Outcome of XXXX using targeted stepwise immunosuppressive treatment strategy.

@entity1 @entity8 @entity1009 @entity205 @entity454
BACKGROUND: The natural course of @entity8 ( @entity8 ) is variable and the role of immunosuppressive therapy is controversial. In our centre, the strategy has been conservative: the immunomodulating treatment (glucocorticoids and/or @entity205 ) has been targeted to @entity1 at high risk of developing progressive @entity8 and the cytotoxic drugs have been used cautiously. The aim of this retrospective observational study was to evaluate the efficacy of this strategy. METHODS: We evaluated the clinical course and outcome of @entity8 @entity1 diagnosed between 1993 and 2003. Risk assessment was done during an observation period of >= 6 months after the initial renal biopsy. @entity1 were followed up until death, the development of @entity454 ( @entity454 ) or the last clinical visit (before December 2006). Treatments and their side effects were recorded. RESULTS: One hundred and forty-two @entity1 with @entity8 were diagnosed of which 81 were idiopathic. The clinical course of 76 @entity8 @entity1 (38 high risk and 38 low risk) were followed up [mean duration 66    40 (median 59) months]. Thirty-five @entity1 were treated with immunosuppressive drugs, and at last follow-up, 71% of them were in complete or partial remission. The overall response rate of this therapy was 83%. 11% of the high-risk @entity1 had reached @entity454 . For the high-risk @entity1 , 10-year survival (alive with glomerular filtration rate >10 mL/ @entity1009 .73 m(2)) was 79%. No major side effects were observed. CONCLUSIONS: This study suggests that targeted, stepwise, cytotoxic drug-sparing immunosuppressive treatment in @entity8 was associated with favourable renal, as well as overall survival among @entity1 at risk of developing @entity454 .
