Document Detail


Evaluation and management of steroid-sensitive nephrotic syndrome.
MedLine Citation:
PMID:  18332709     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: This review examines new literature published in 2006 and 2007 on steroid-sensitive nephrotic syndrome. RECENT FINDINGS: Steroid-sensitive nephrotic syndrome has long been thought to be due to lymphocyte-derived circulating factors leading to podocyte injury with subsequent proteinuria. New studies support this mechanism and implicate the T helper 2 cytokine IL-13. In addition a genetic mutation in familial nephrotic syndrome has been reported in a child, who responded to corticosteroid therapy. There are new clinical trial data supporting the efficacy of levamisole in steroid-sensitive nephrotic syndrome and preliminary trial data on mycophenolate mofetil supporting its efficacy as a steroid-sparing agent. Case reports support the use of the B cell-depleting antibody rituximab in steroid-sensitive nephrotic syndrome. Finally there is a meta-analysis of six studies suggesting an increase in the incidence of focal and segmental glomerulosclerosis in steroid-sensitive nephrotic syndrome over the last 20 years. SUMMARY: Progress has been made towards elucidating the cause of steroid-sensitive nephrotic syndrome. Data from adequately powered randomized controlled trials are still required to evaluate therapies for frequently relapsing and steroid-dependent steroid-sensitive nephrotic syndrome.
Authors:
Elisabeth M Hodson; Stephen I Alexander
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in pediatrics     Volume:  20     ISSN:  1040-8703     ISO Abbreviation:  Curr. Opin. Pediatr.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-11     Completed Date:  2008-08-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9000850     Medline TA:  Curr Opin Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  145-50     Citation Subset:  IM    
Affiliation:
Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia. Elisah@chw.edu.au
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MeSH Terms
Descriptor/Qualifier:
Animals
Child
Cyclophosphamide / therapeutic use
Cyclosporine / therapeutic use
Glucocorticoids / therapeutic use*
Humans
Immunosuppressive Agents / therapeutic use
Mycophenolic Acid / analogs & derivatives,  therapeutic use
Nephrotic Syndrome / drug therapy*,  epidemiology,  etiology
Treatment Outcome
Chemical
Reg. No./Substance:
0/Glucocorticoids; 0/Immunosuppressive Agents; 128794-94-5/mycophenolate mofetil; 24280-93-1/Mycophenolic Acid; 50-18-0/Cyclophosphamide; 59865-13-3/Cyclosporine

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


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