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Clinical journal of the american society of nephrology skip to main page content home current issue advertise subscribe archives feedback alerts rss â  classifieds help search submit advanced search user name password sign in have we changed the outcome in membranous nephropathy? A propensity study on the role of immunosuppressive therapy daniel c. Cattran *, heather n. cheap viagra fast shipping overnight Reich *, s. Joseph kim *, stã©phan troyanov † *department of nephrology, toronto general hospital, university health network, toronto, ontario, canada; and †department of nephrology, hã´pital du sacrã©-coeur de montrã©al, montreal, quebec, canada correspondence: dr. Daniel c. Cattran, ncsb 11-1256 585 university avenue, toronto, ontario, canada m5g 2n2. cheap viagra online Phone: 416-340-4187; fax: 416-340-3714; e-mail: daniel. viagra no prescription Cattran{at}uhn. On. yahoo account hacked viagra Ca abstract background and objectives the long-term effect of immunosuppressive therapy (is) on kidney survival in idiopathic membranous nephropathy (mgn) is debated. viagra canada The introduction of renin angiotensin blockade, rigorous bp control, and the increasing age at presentation of patients with mgn adds further uncertainty. anwendung viagra 100mg Given these important changes, we sought to determine whether implementation of is has altered outcome. Design, setting, participants, & methods we prospectively evaluated 280 incident mgn patients from three distinct 10-year periods starting from 1975. Results we found expected changes in treatment regimens but also variations in age, renal function, severity of proteinuria, and bp at presentation over this time. can you buy viagra spain Outcomes did not differ over time if these significant variations in clinical characteristics were not accounted for across the eras. viagra coupon The effect of is in the 57 patients treated with currently recommended regimens was assessed using propensity adjustment to address selection bias and the effect of newer, conservative therapies. A propensity score estimating the probability of receiving is permitted the pairing of 39 treated patients with controls with similar high risk of progression of clinical features. Using this approach, is was associated not only with remissions in proteinuria but also with substantially improved renal survival. Conclusions the study confirms that patient presenting characteristics and management regimens have changed significantly over time and the natural history of mgn has been altered. A study of propensity-matched patients confirms that current recommendations for is have improved outcomes in mgn patients at high risk of progression. Received december 13, 2010. Accepted march 7, 2011. can you buy viagra spain Copyright â© 2011 by the american society of ne. viagra for sale