B형 간염과 연관된 신증후군 치료에 Lamivudine 단독요법과 Lamivudine 및 Steroid 병합요법의 비교

Treatment of nephrotic syndrome associated with hepatitis B are controversial, but some patients may respond to interferon therapy. Steroid therapy in these patients could be limited, because it may aggravate hepatitis with the acute viral replication. Lamivudine may also be effective in reducing vi...

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Veröffentlicht in:Kidney research and clinical practice 1999-07, Vol.18 (4), p.550
Hauptverfasser: 신석균, Sug Kyun Shin, 류동렬, Dong Ryeol Ryu, 황재하, Jae Hwa Hwang, 송현용, Hyun Yong Song, 강신욱, Hyun Jin Noh, 최규헌, Shin Wook Kang, 한광협, Kyu Hun Choi, 하성규, Kwang Hyub Han, 한대석, Sung Kyu Ha, 노현진, Dae Suk Han, 이호영, Ho Yung Lee
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container_issue 4
container_start_page 550
container_title Kidney research and clinical practice
container_volume 18
creator 신석균
Sug Kyun Shin
류동렬
Dong Ryeol Ryu
황재하
Jae Hwa Hwang
송현용
Hyun Yong Song
강신욱
Hyun Jin Noh
최규헌
Shin Wook Kang
한광협
Kyu Hun Choi
하성규
Kwang Hyub Han
한대석
Sung Kyu Ha
노현진
Dae Suk Han
이호영
Ho Yung Lee
description Treatment of nephrotic syndrome associated with hepatitis B are controversial, but some patients may respond to interferon therapy. Steroid therapy in these patients could be limited, because it may aggravate hepatitis with the acute viral replication. Lamivudine may also be effective in reducing viral burden and may convert patients from HBsAg and HBeAg positive to negative. But there was no report for the usefulness of lamivudine in treatment of these patients. We performed a randomized comparative study to assess the usefulness of lamivudine and the effect of steroid in the use of lamivudine in treatment of B-viral associated nephrotic syndrome. Twelve patients(M:F=1:0.2, mean age 34.3 years, MCD 1, MPGN 5, MGN 6 patients) suspected to have the acute viral replication with nephrotic syndrome were included. They were randomly assigned to receive lamivudine and steroid combination therapy(group I, 150mg of lamivudine with high-dose steroid, 1mg/kg/day, orally once daily in 6 patients) or lamivudine alone therapy(group Ⅱ, 150 mg of lamivudine orally once daily alone in 6 patients). The duration of lamivudine use was 6 months in both groups, and that of steroid use was 6 weeks in group 1. Then, lamivudine and steroid were tapered according to the amount of proteinuria and serum HBV-DNA titer. All patients were closely monitored every 2 months with clinical, bioche mical, and serological parameters for 10 months. The rate of negative sero-conversion of HBV- DNA were 91.7%(11/12) at 2 months of lamivudine therapy in all patients, and there was no difference between group Ⅰ and Ⅱ(83.3% vs. 100%, p>0.05). In group I, there were a significant decreases of mean serum HBV-DNA values(899.2±711.9 vs. 31.4±32.7, 12.7±27.6, and 137.2±278.1pg/ml, p
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Steroid therapy in these patients could be limited, because it may aggravate hepatitis with the acute viral replication. Lamivudine may also be effective in reducing viral burden and may convert patients from HBsAg and HBeAg positive to negative. But there was no report for the usefulness of lamivudine in treatment of these patients. We performed a randomized comparative study to assess the usefulness of lamivudine and the effect of steroid in the use of lamivudine in treatment of B-viral associated nephrotic syndrome. Twelve patients(M:F=1:0.2, mean age 34.3 years, MCD 1, MPGN 5, MGN 6 patients) suspected to have the acute viral replication with nephrotic syndrome were included. They were randomly assigned to receive lamivudine and steroid combination therapy(group I, 150mg of lamivudine with high-dose steroid, 1mg/kg/day, orally once daily in 6 patients) or lamivudine alone therapy(group Ⅱ, 150 mg of lamivudine orally once daily alone in 6 patients). The duration of lamivudine use was 6 months in both groups, and that of steroid use was 6 weeks in group 1. Then, lamivudine and steroid were tapered according to the amount of proteinuria and serum HBV-DNA titer. All patients were closely monitored every 2 months with clinical, bioche mical, and serological parameters for 10 months. The rate of negative sero-conversion of HBV- DNA were 91.7%(11/12) at 2 months of lamivudine therapy in all patients, and there was no difference between group Ⅰ and Ⅱ(83.3% vs. 100%, p>0.05). In group I, there were a significant decreases of mean serum HBV-DNA values(899.2±711.9 vs. 31.4±32.7, 12.7±27.6, and 137.2±278.1pg/ml, p<0.05, respectively), proteinuria(11.0±3.6 vs. 3.9±2.3, 2.1±2.3, and 2.5±3.1g/d, p<0.05, respectively), and SGPT (57.7±18.9 vs. 30.5±12.4, 23.8±10.2, and 26.0±10.4 IU/L, p<0.05, respectively) measured at 2, 6, and 10months compared to before therapy, and serum albumin levels were significantly increased at 2, 6, and 10months compared to before therapy(2.2±0.5 vs. 3.1±0.5, 3.9±0.8, and 3.9±0.9g/dL, p<0.05, respectively). In group Ⅱ, serum HBV-DNA was significantly decreased at 2, 6, and 10 months compared to before therapy(358.8±369.3 vs. 19.1±27.0, 0.0±0.0, and 0.0±0.0pg/ml, p<0.05, respectively), and proteinuria and SGPT were significantly decreased at 6 and 10 months compared to before therapy(8.5±5.5 vs. 2.6±1.3 and 2.1±2.3g/d, p<0.05; 67.5±43.0 vs. 25.3±11.6 and 31.5±9.2IU/L, p<0.05, respectively). Serum albumin levels were significantly increased at 10 months compared to before therapy(2.8±0.8 vs. 4.3±0.1g/dL, p<0.05). Serum HBV-DNA levels rebounded in two patients of group Ⅰ, but none was observed in group Ⅱ. No serious adverse events were observed in all the patients. In conclusion, lamivudine and steroid combination therapy may more rapidly decrease proteinuria than lamivudine alone in B-viral associated nephrotic syndrome, but may induce the rebound of serum HBV-DNA.]]></description><identifier>ISSN: 2211-9132</identifier><language>kor</language><publisher>대한신장학회</publisher><subject>Hepatitis B virus ; Lamivudine ; Nephrotic syndrome ; Steroid</subject><ispartof>Kidney research and clinical practice, 1999-07, Vol.18 (4), p.550</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785</link.rule.ids></links><search><creatorcontrib>신석균</creatorcontrib><creatorcontrib>Sug Kyun Shin</creatorcontrib><creatorcontrib>류동렬</creatorcontrib><creatorcontrib>Dong Ryeol Ryu</creatorcontrib><creatorcontrib>황재하</creatorcontrib><creatorcontrib>Jae Hwa Hwang</creatorcontrib><creatorcontrib>송현용</creatorcontrib><creatorcontrib>Hyun Yong Song</creatorcontrib><creatorcontrib>강신욱</creatorcontrib><creatorcontrib>Hyun Jin Noh</creatorcontrib><creatorcontrib>최규헌</creatorcontrib><creatorcontrib>Shin Wook Kang</creatorcontrib><creatorcontrib>한광협</creatorcontrib><creatorcontrib>Kyu Hun Choi</creatorcontrib><creatorcontrib>하성규</creatorcontrib><creatorcontrib>Kwang Hyub Han</creatorcontrib><creatorcontrib>한대석</creatorcontrib><creatorcontrib>Sung Kyu Ha</creatorcontrib><creatorcontrib>노현진</creatorcontrib><creatorcontrib>Dae Suk Han</creatorcontrib><creatorcontrib>이호영</creatorcontrib><creatorcontrib>Ho Yung Lee</creatorcontrib><title>B형 간염과 연관된 신증후군 치료에 Lamivudine 단독요법과 Lamivudine 및 Steroid 병합요법의 비교</title><title>Kidney research and clinical practice</title><addtitle>Kidney Research and Clinical Practice(구 대한신장학회지)</addtitle><description><![CDATA[Treatment of nephrotic syndrome associated with hepatitis B are controversial, but some patients may respond to interferon therapy. Steroid therapy in these patients could be limited, because it may aggravate hepatitis with the acute viral replication. Lamivudine may also be effective in reducing viral burden and may convert patients from HBsAg and HBeAg positive to negative. But there was no report for the usefulness of lamivudine in treatment of these patients. We performed a randomized comparative study to assess the usefulness of lamivudine and the effect of steroid in the use of lamivudine in treatment of B-viral associated nephrotic syndrome. Twelve patients(M:F=1:0.2, mean age 34.3 years, MCD 1, MPGN 5, MGN 6 patients) suspected to have the acute viral replication with nephrotic syndrome were included. They were randomly assigned to receive lamivudine and steroid combination therapy(group I, 150mg of lamivudine with high-dose steroid, 1mg/kg/day, orally once daily in 6 patients) or lamivudine alone therapy(group Ⅱ, 150 mg of lamivudine orally once daily alone in 6 patients). The duration of lamivudine use was 6 months in both groups, and that of steroid use was 6 weeks in group 1. Then, lamivudine and steroid were tapered according to the amount of proteinuria and serum HBV-DNA titer. All patients were closely monitored every 2 months with clinical, bioche mical, and serological parameters for 10 months. The rate of negative sero-conversion of HBV- DNA were 91.7%(11/12) at 2 months of lamivudine therapy in all patients, and there was no difference between group Ⅰ and Ⅱ(83.3% vs. 100%, p>0.05). In group I, there were a significant decreases of mean serum HBV-DNA values(899.2±711.9 vs. 31.4±32.7, 12.7±27.6, and 137.2±278.1pg/ml, p<0.05, respectively), proteinuria(11.0±3.6 vs. 3.9±2.3, 2.1±2.3, and 2.5±3.1g/d, p<0.05, respectively), and SGPT (57.7±18.9 vs. 30.5±12.4, 23.8±10.2, and 26.0±10.4 IU/L, p<0.05, respectively) measured at 2, 6, and 10months compared to before therapy, and serum albumin levels were significantly increased at 2, 6, and 10months compared to before therapy(2.2±0.5 vs. 3.1±0.5, 3.9±0.8, and 3.9±0.9g/dL, p<0.05, respectively). In group Ⅱ, serum HBV-DNA was significantly decreased at 2, 6, and 10 months compared to before therapy(358.8±369.3 vs. 19.1±27.0, 0.0±0.0, and 0.0±0.0pg/ml, p<0.05, respectively), and proteinuria and SGPT were significantly decreased at 6 and 10 months compared to before therapy(8.5±5.5 vs. 2.6±1.3 and 2.1±2.3g/d, p<0.05; 67.5±43.0 vs. 25.3±11.6 and 31.5±9.2IU/L, p<0.05, respectively). Serum albumin levels were significantly increased at 10 months compared to before therapy(2.8±0.8 vs. 4.3±0.1g/dL, p<0.05). Serum HBV-DNA levels rebounded in two patients of group Ⅰ, but none was observed in group Ⅱ. No serious adverse events were observed in all the patients. In conclusion, lamivudine and steroid combination therapy may more rapidly decrease proteinuria than lamivudine alone in B-viral associated nephrotic syndrome, but may induce the rebound of serum HBV-DNA.]]></description><subject>Hepatitis B virus</subject><subject>Lamivudine</subject><subject>Nephrotic syndrome</subject><subject>Steroid</subject><issn>2211-9132</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><recordid>eNpjYeA0MjI01LU0NDbiYOAtLs5MMjA1MDc2MbOw4GSocHo7Y6rCqw0tb6bvebV5j8Kb6RtebWl4PWGOwpvuBW-WzX07u-XV1g0Kb3bOeL245830CQo-ibmZZaUpmXmpCq-7V7zub30za8rrTVNBepGlNvQrBJekFuVnpii83jzx7dSVEGVv5s5QeL0TaOQEHgbWtMSc4lReKM3NIO3mGuLsoZudWVwcX1CUmZtYVBlvaGFpYGRpYYxfFgA49WLQ</recordid><startdate>19990730</startdate><enddate>19990730</enddate><creator>신석균</creator><creator>Sug Kyun Shin</creator><creator>류동렬</creator><creator>Dong Ryeol Ryu</creator><creator>황재하</creator><creator>Jae Hwa Hwang</creator><creator>송현용</creator><creator>Hyun Yong Song</creator><creator>강신욱</creator><creator>Hyun Jin Noh</creator><creator>최규헌</creator><creator>Shin Wook Kang</creator><creator>한광협</creator><creator>Kyu Hun Choi</creator><creator>하성규</creator><creator>Kwang Hyub Han</creator><creator>한대석</creator><creator>Sung Kyu Ha</creator><creator>노현진</creator><creator>Dae Suk Han</creator><creator>이호영</creator><creator>Ho Yung Lee</creator><general>대한신장학회</general><scope>HZB</scope><scope>Q5X</scope></search><sort><creationdate>19990730</creationdate><title>B형 간염과 연관된 신증후군 치료에 Lamivudine 단독요법과 Lamivudine 및 Steroid 병합요법의 비교</title><author>신석균 ; Sug Kyun Shin ; 류동렬 ; Dong Ryeol Ryu ; 황재하 ; Jae Hwa Hwang ; 송현용 ; Hyun Yong Song ; 강신욱 ; Hyun Jin Noh ; 최규헌 ; Shin Wook Kang ; 한광협 ; Kyu Hun Choi ; 하성규 ; Kwang Hyub Han ; 한대석 ; Sung Kyu Ha ; 노현진 ; Dae Suk Han ; 이호영 ; Ho Yung Lee</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-kiss_primary_18902983</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>kor</language><creationdate>1999</creationdate><topic>Hepatitis B virus</topic><topic>Lamivudine</topic><topic>Nephrotic syndrome</topic><topic>Steroid</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>신석균</creatorcontrib><creatorcontrib>Sug Kyun Shin</creatorcontrib><creatorcontrib>류동렬</creatorcontrib><creatorcontrib>Dong Ryeol Ryu</creatorcontrib><creatorcontrib>황재하</creatorcontrib><creatorcontrib>Jae Hwa Hwang</creatorcontrib><creatorcontrib>송현용</creatorcontrib><creatorcontrib>Hyun Yong Song</creatorcontrib><creatorcontrib>강신욱</creatorcontrib><creatorcontrib>Hyun Jin Noh</creatorcontrib><creatorcontrib>최규헌</creatorcontrib><creatorcontrib>Shin Wook Kang</creatorcontrib><creatorcontrib>한광협</creatorcontrib><creatorcontrib>Kyu Hun Choi</creatorcontrib><creatorcontrib>하성규</creatorcontrib><creatorcontrib>Kwang Hyub Han</creatorcontrib><creatorcontrib>한대석</creatorcontrib><creatorcontrib>Sung Kyu Ha</creatorcontrib><creatorcontrib>노현진</creatorcontrib><creatorcontrib>Dae Suk Han</creatorcontrib><creatorcontrib>이호영</creatorcontrib><creatorcontrib>Ho Yung Lee</creatorcontrib><collection>KISS</collection><collection>Korean Studies Information Service System (KISS) B-Type</collection><jtitle>Kidney research and clinical practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>신석균</au><au>Sug Kyun Shin</au><au>류동렬</au><au>Dong Ryeol Ryu</au><au>황재하</au><au>Jae Hwa Hwang</au><au>송현용</au><au>Hyun Yong Song</au><au>강신욱</au><au>Hyun Jin Noh</au><au>최규헌</au><au>Shin Wook Kang</au><au>한광협</au><au>Kyu Hun Choi</au><au>하성규</au><au>Kwang Hyub Han</au><au>한대석</au><au>Sung Kyu Ha</au><au>노현진</au><au>Dae Suk Han</au><au>이호영</au><au>Ho Yung Lee</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>B형 간염과 연관된 신증후군 치료에 Lamivudine 단독요법과 Lamivudine 및 Steroid 병합요법의 비교</atitle><jtitle>Kidney research and clinical practice</jtitle><addtitle>Kidney Research and Clinical Practice(구 대한신장학회지)</addtitle><date>1999-07-30</date><risdate>1999</risdate><volume>18</volume><issue>4</issue><spage>550</spage><pages>550-</pages><issn>2211-9132</issn><abstract><![CDATA[Treatment of nephrotic syndrome associated with hepatitis B are controversial, but some patients may respond to interferon therapy. Steroid therapy in these patients could be limited, because it may aggravate hepatitis with the acute viral replication. Lamivudine may also be effective in reducing viral burden and may convert patients from HBsAg and HBeAg positive to negative. But there was no report for the usefulness of lamivudine in treatment of these patients. We performed a randomized comparative study to assess the usefulness of lamivudine and the effect of steroid in the use of lamivudine in treatment of B-viral associated nephrotic syndrome. Twelve patients(M:F=1:0.2, mean age 34.3 years, MCD 1, MPGN 5, MGN 6 patients) suspected to have the acute viral replication with nephrotic syndrome were included. They were randomly assigned to receive lamivudine and steroid combination therapy(group I, 150mg of lamivudine with high-dose steroid, 1mg/kg/day, orally once daily in 6 patients) or lamivudine alone therapy(group Ⅱ, 150 mg of lamivudine orally once daily alone in 6 patients). The duration of lamivudine use was 6 months in both groups, and that of steroid use was 6 weeks in group 1. Then, lamivudine and steroid were tapered according to the amount of proteinuria and serum HBV-DNA titer. All patients were closely monitored every 2 months with clinical, bioche mical, and serological parameters for 10 months. The rate of negative sero-conversion of HBV- DNA were 91.7%(11/12) at 2 months of lamivudine therapy in all patients, and there was no difference between group Ⅰ and Ⅱ(83.3% vs. 100%, p>0.05). In group I, there were a significant decreases of mean serum HBV-DNA values(899.2±711.9 vs. 31.4±32.7, 12.7±27.6, and 137.2±278.1pg/ml, p<0.05, respectively), proteinuria(11.0±3.6 vs. 3.9±2.3, 2.1±2.3, and 2.5±3.1g/d, p<0.05, respectively), and SGPT (57.7±18.9 vs. 30.5±12.4, 23.8±10.2, and 26.0±10.4 IU/L, p<0.05, respectively) measured at 2, 6, and 10months compared to before therapy, and serum albumin levels were significantly increased at 2, 6, and 10months compared to before therapy(2.2±0.5 vs. 3.1±0.5, 3.9±0.8, and 3.9±0.9g/dL, p<0.05, respectively). In group Ⅱ, serum HBV-DNA was significantly decreased at 2, 6, and 10 months compared to before therapy(358.8±369.3 vs. 19.1±27.0, 0.0±0.0, and 0.0±0.0pg/ml, p<0.05, respectively), and proteinuria and SGPT were significantly decreased at 6 and 10 months compared to before therapy(8.5±5.5 vs. 2.6±1.3 and 2.1±2.3g/d, p<0.05; 67.5±43.0 vs. 25.3±11.6 and 31.5±9.2IU/L, p<0.05, respectively). Serum albumin levels were significantly increased at 10 months compared to before therapy(2.8±0.8 vs. 4.3±0.1g/dL, p<0.05). Serum HBV-DNA levels rebounded in two patients of group Ⅰ, but none was observed in group Ⅱ. No serious adverse events were observed in all the patients. In conclusion, lamivudine and steroid combination therapy may more rapidly decrease proteinuria than lamivudine alone in B-viral associated nephrotic syndrome, but may induce the rebound of serum HBV-DNA.]]></abstract><pub>대한신장학회</pub><tpages>10</tpages></addata></record>
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ispartof Kidney research and clinical practice, 1999-07, Vol.18 (4), p.550
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subjects Hepatitis B virus
Lamivudine
Nephrotic syndrome
Steroid
title B형 간염과 연관된 신증후군 치료에 Lamivudine 단독요법과 Lamivudine 및 Steroid 병합요법의 비교
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