What is Ponticelli regimen?

What is Ponticelli regimen?

The Ponticelli regimen is a combination of drug treatments which is used to treat a kidney disease called membranous nephropathy. The Ponticelli regimen is named after Professor Claudio Ponticelli, an Italian doctor, who first demonstrated that it was effective in treating some people with membranous nephropathy.

How do you manage membranous nephropathy?

If you’re at low risk of advanced kidney disease, treatment of membranous nephropathy usually begins by taking the following steps:

1. Take blood pressure medication.
2. Decrease swelling (edema).
3. Control cholesterol.
4. Lower your risk for blood clots.
5. Cut back on salt.

Is membranous nephropathy treatable?

There’s no absolute cure for membranous nephropathy, but successful treatment can lead to remission of proteinuria and a good long-term outlook.

How long does rituximab take to work for membranous nephropathy?

During a median follow-up of 29 months after rituximab administration, 65 patients achieved complete or partial remission. The median time to remission was 7.1 months. All 24 patients who had at least 4 years of follow-up achieved complete or partial remission.

What is modified Ponticelli regimen?

Background: Modified Ponticelli regimen (mPR), consisting of cyclical steroids and cyclophosphamide, is the most established therapy for primary membranous nephropathy (MN). Yet, the potential toxicity of this treatment regimen poses a significant concern.

How do you rule out Membranoproliferative glomerulonephritis?

What tests are done to find out if I have membranoproliferative glomerulonephritis?

1. Urine test: A urine test will help find protein and blood in your urine.
2. Blood test: A blood test will help find levels of protein, cholesterol, and wastes in your blood.

Can diabetes cause membranous nephropathy?

Membranous glomerulopathy is a common cause of primary glomerular disease in diabetics [6–8]. It can occur either as an isolated lesion or superimposed with diabetic nephropathy (DN). Nephrotic syndrome occurs late in the course of DN, indicating an advanced stage of glomerular damage [9].

Does Rituxan affect the kidneys?

Kidney Problems: Especially if you are receiving Rituxan for non–Hodgkin’s lymphoma (NHL). Rituxan can cause severe kidney problems that lead to death. Your healthcare provider should do blood tests to check how well your kidneys are working.

What is the toxicity unique to cyclophosphamide?

Clinically, damage to the bladder (haemorrhagic cystitis), immunosuppression (when not desired) and alopecia are the most significant toxicities associated with cyclophosphamide. Cardiotoxicity is also a possibility when very high doses are given.

Is oral cyclophosphamide effective as a first-line treatment for cyclosporine toxicity?

Current recommendations include oral cyclophosphamide combined with steroids (modified Ponticelli regimen) as first-line treatment in patients who are high risk. However, concerns about the cumulative toxicity of oral cyclophosphamide persist.

What is the a typical regimen for Ponticelli syndrome?

A typical regimen (the “modified Ponticelli protocol”, JASN 1988; 9:444) is shown below: Months 1, 3, and 5: Solumedrol 1000mg iv daily x 3 days then prednisone 0.4 mg/kg/d x 27 days. Months 2, 4, and 6: CTX 2.5mg/kg PO daily x 30 days.

What is the Ponticelli protocol for prednisone?

The Ponticelli Protocol. Months 1, 3, and 5: Solumedrol 1000mg iv daily x 3 days then prednisone 0.4 mg/kg/d x 27 days. Months 2, 4, and 6: CTX 2.5mg/kg PO daily x 30 days.

What is the Ponticelli protocol for the treatment of glomerular disease?

The Ponticelli Protocol. One of the landmark protocols for glomerular disease is the so-called “Ponticelli Protocol”, used in the treatment of idiopathic membranous nephropathy. The 1992 NEJM paper describes the randomization of a group of patients with biopsy-proven membranous nephropathy to one of two regiments:…