EFFECTS OF TACROLIMUS COMBINED WITH GLUCOCORTICOID ON REFRACTORY NEPHROPATHY SYNDROME AND THE INFLUENCES ON SERUM IL-6 AND TNF-Α

Shi Su¹, Yanhai Song¹, Huanyu Song¹, Jie Guan¹, Yuling Zheng¹, Daibao Lv², Lianming Wang^{1, *} 

¹Clinical Laboratory, The First Affiliated Hospital of Harbin Medical University, Harbin150001, Heilongjiang Province, China - ²Internal Medicine-Cardiovascular Department, The First Affiliated Hospital of Harbin Medical University, Harbin150001, Heilongjiang Province, China

This research aimed at analyzing the effects of tacrolimus combined with glucocorticoid on refractory nephropathy syndrome (RNS) and its influencing factors. A total of 156 RNS patients admitted to our hospital were selected as research objects, patients treated with tacrolimus combined with glucocorticoid were taken as group A (79 cases), and patients treated with glucocorticoid were taken as group B (77 cases). Therapeutic effects and incidence rate of adverse reactions of both groups were assessed. Blood fat and renal function indexes were observed before and after treatment. Serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels before and after treatment were tested by enzyme-linked immunosorbent assay (ELISA). Compared with group B, the effective rate of group A was higher (P<0.001), and the incidence rate of adverse reactions was lower (P<0.05). After treatment, serum total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), urea nitrogen (BUN), IL-6, TNF-α, and 24-hour urine protein levels in group A were lower than those in group B (P<0.05), while those of high density lipoprotein (HDL) were higher (P<0.01). Multivariate Logistic regression analysis manifested that patients with IL-6 (<139.20 pg/ml), TNF-α level (<197.00 pg/ml) and tacrolimus combined with glucocorticoid before treatment had lower risks of ineffective treatments. In conclusion, tacrolimus combined with glucocorticoid has good clinical effects on RNS. Before treatment, risks of ineffective treatments for RNS patients with IL-6 (<139.20 pg/ml), TNF-α level (<197.00 pg/ml) and tacrolimus combined with glucocorticoid are reduced.