Skip to main content

Advertisement

Log in

One-center experience with cyclosporine in refractory nephrotic syndrome in children

  • ORIGINAL ARTICLE
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

 Uncontrolled or refractory nephrotic syndrome (NS), seen in a variety of glomerular disorders, leads to end-stage renal disease (ESRD). This study describes the use and efficacy of cyclosporine (CSA) for the treatment of refractory NS in 83 children seen over a 10-year period. The histological diagnosis leading to the NS was focal segmental glomerulosclerosis (FSGS) in 51% (n=42), IgM nephropathy in 20% (n=17), membranoproliferative glomerulonephritis in 10% (n=8), lupus nephritis in 6% (n=5), human immunodeficiency virus (HIV) nephropathy in 5% (n=4), minimal change disease in 7% (n=6), and membranous nephropathy in 1% (n=1) of patients. During CSA therapy the mean proteinuria of the study population decreased from 5.14 g/24 h (4.80 g/m2 per 24 h) to 1.23 g/24 h (0.92 g/m2 per 24 h) (P<0.001), the mean serum albumin increased from 2.13 g/dl to 3.53 g/dl (P<0.001), the mean serum cholesterol decreased from 364 mg/dl to 223 mg/dl (P<0.001), and the mean serum creatinine increased from 0.77 mg/dl to 1.2 mg/dl (P<0.01). When analyzed by histological diagnosis, similar significant trends of reduction in proteinuria were seen in all but the lupus group. There was a rise in serum creatinine following the use of CSA in patients with FSGS, lupus nephritis, and HIV nephropathy; however the elevated serum creatinine was only significant in patients with FSGS. At the end of the study period, 20 patients had reached ESRD, of which 11 had FSGS, 5 had lupus nephritis, and 4 were patients with HIV nephropathy. Fifty-four patients were in remission at the end of the study period (48 with proteinuria <100 mg/24 h and 6 with proteinuria <500 mg/24 h). In conclusion, among children with refractory NS, CSA induced a remission in a large proportion. However toxicity, as noted by the rise in serum creatinine, was observed in several patients. Since this toxicity may be drug induced or a natural progression of the disease, careful monitoring and close follow-up are essential.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Author information

Authors and Affiliations

Authors

Additional information

Received: 21 October 1997 / Revised: 30 April 1998 / Accepted: 29 May 1998

Rights and permissions

Reprints and permissions

About this article

Cite this article

Singh, A., Tejani, C. & Tejani, A. One-center experience with cyclosporine in refractory nephrotic syndrome in children. Pediatr Nephrol 13, 26–32 (1999). https://doi.org/10.1007/s004670050557

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s004670050557

Navigation