Document Detail


Intravenous pulse cyclophosphamide--is it effective in children with steroid-resistant nephrotic syndrome?
MedLine Citation:
PMID:  13680329     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Treatment of steroid-resistant nephrotic syndrome (SRNS) remains a challenge to pediatric nephrologists. Recently, intravenous cyclophosphamide (IV-CPM) infusion was shown to be effective, safe, and economical for the treatment of SRNS, particularly minimal change disease (MCD), as it results in more sustained remissions, longer periods without proteinuria, and fewer significant side effects at a lower cumulative dose. A prospective study was conducted to evaluate IV-CPM infusions in the management of children with SRNS secondary to MCD or IgM nephropathy. Five patients with SRNS (4 IgM nephropathy and 1 MCD) received six monthly IV-CPM infusions at a dose of 500 mg/m(2). No patient achieved complete or sustained remission. Three patients attained partial remission, which was not sustained for more than 1 month post therapy. One patient progressed rapidly to end-stage renal disease during treatment. Side effects included vomiting in four patients and alopecia in one patient. Conclusion: IV-CPM pulse therapy at a dose of 500 mg/m(2) is unsuccessful in obtaining complete or sustained remission in children with SRNS secondary to IGM nephropathy or MCD. Further randomized controlled studies with higher doses are required.
Authors:
Hammad O Alshaya; Jaudah A Al-Maghrabi; Jameela A Kari
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2003-09-17
Journal Detail:
Title:  Pediatric nephrology (Berlin, Germany)     Volume:  18     ISSN:  0931-041X     ISO Abbreviation:  Pediatr. Nephrol.     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-10-30     Completed Date:  2004-06-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8708728     Medline TA:  Pediatr Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1143-6     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, King Abdul Aziz University Hospital, PO Box 80215, Jeddah 21589, Saudi Arabia.
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MeSH Terms
Descriptor/Qualifier:
Child, Preschool
Cyclophosphamide / administration & dosage*,  adverse effects
Drug Resistance
Female
Glomerulonephritis, IGA / complications
Humans
Immunosuppressive Agents / administration & dosage*,  adverse effects
Infant
Injections, Intravenous
Male
Nephrosis, Lipoid / complications
Nephrotic Syndrome / drug therapy*,  etiology
Pulse Therapy, Drug
Steroids / therapeutic use
Treatment Failure
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 0/Steroids; 50-18-0/Cyclophosphamide

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


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