Document Detail


Effect of cyclosporine therapy with low doses of corticosteroids on idiopathic nephrotic syndrome.
MedLine Citation:
PMID:  20447050     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cyclosporine (CyA) has an immunosuppressive effect that might suggest a therapeutic role in idiopathic glomerular conditions. We focused on the optimization of CyA treatment control in patients with idiopathic nephrotic syndrome by using trough-level CyA measurements (C0) and the 2-h postdose levels (C2). Twenty-two patients (14 male, 8 female) with idiopathic nephrotic syndrome and the mean age of 51 +/- 18 months (mean [M] +/- standard deviation [SD]) were enrolled in our study during a period of 10 months (range: 3-18 months). All of the patients received CyA (2-3 mg/kg) in combination with methylprednisolone. In the present study protocol CyA concentrations (C0, C2), renal function, lipid profile, and degree of proteinuria were determined. The mean proteinuria of our patients before treatment was 11 972 +/- 7953 mg/24 H (+/-SD) and the mean creatinine level (Cr) was 0.99 +/- 0.37 mg/dL (+/-SD). Proteinuria decreased significantly already from the first month of therapy with CyA to 3578 +/- 2470 mg/24 H (M+/- SD), and during the whole study period this reduction was significant (0.56 +/- 0.37 gr/24 H (M +/- SD), P < 0.05). At the same time renal function preserved, 1.09 +/- 0.48 mg/dL (M +/- SD). The blood levels of C0 were 135.10 +/- 97.36 ng/mL (M +/- SD) and the blood levels of C2 were 725 +/- 256 ng/mL (M +/- SD) at the first month of therapy. At the same time renal function preserved, 1.09 +/- 0.48 mg/dL (M +/- SD). Total cholesterol levels reduced significantly during study period (276.89 +/- 45.57 to 200.67 +/- 40.27 mg/dL [M +/- SD]). The mean number of antihypertensive medication remained the same. The whole therapeutic protocol did not provoke any kind of side effects and CyA was quite tolerated by our patients. Treatment of idiopathic nephrotic syndrome with low doses of CyA with methylprednisolone leads to remission of proteinuria without deterioration of renal function. Blood levels of C0 for monitoring and treatment of nephrotic syndrome agrees with recent literature, while our study focus on establishing the proper levels of C2 for the treatment of nephrotic syndrome. The efficacy of CyA is combined with safety and tolerance.
Authors:
Ioannis Griveas; George Visvardis; Dorothea Papadopoulou; Lidia Nakopolou; Evaggelos Karanikas; Konstantina Gogos; George Stavianoudakis
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Artificial organs     Volume:  34     ISSN:  1525-1594     ISO Abbreviation:  Artif Organs     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-05-07     Completed Date:  2010-07-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802778     Medline TA:  Artif Organs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  234-7     Citation Subset:  IM    
Affiliation:
Nephrology Department, 417 Veterans Army Administration Hospital (NIMTS), Athens, Greece. giannisgriv@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / administration & dosage*
Biological Markers / blood
Child, Preschool
Cholesterol / blood
Creatinine / blood
Cyclosporine / adverse effects,  blood,  therapeutic use*
Drug Therapy, Combination
Female
Humans
Immunosuppressive Agents / adverse effects,  blood,  therapeutic use*
Kidney / drug effects,  physiopathology
Male
Methylprednisolone / administration & dosage*
Nephrotic Syndrome / blood,  drug therapy*,  physiopathology
Proteinuria / drug therapy
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Biological Markers; 0/Immunosuppressive Agents; 57-88-5/Cholesterol; 59865-13-3/Cyclosporine; 60-27-5/Creatinine; 83-43-2/Methylprednisolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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