Document Detail


Prospective 5-year follow-up of cyclosporine treatment in children with steroid-resistant nephrosis.
MedLine Citation:
PMID:  23314441     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cyclosporine has improved remission rates in children with steroid-resistant nephrotic syndrome (SRNS). However, little prospective long-term follow-up data is available.
METHODS: We prospectively followed and analyzed 5-year outcomes of all 35 patients enrolled in our previous prospective multicenter trial with cyclosporine and steroids in children with SRNS. At enrollment, 23 cases were classified as minimal change (MC), five as diffuse mesangial proliferation (DMP), and seven as focal segmental glomerulosclerosis (FSGS).
RESULTS: Renal survival at 5 years (median 7.7 years) was 94.3 %. Patient status was complete remission (CR) in 31 (88.6 %) (MC/DMP, 25; FSGS, 6); partial remission in one (FSGS); and non-remission in three (MC/DMP), including chronic kidney disease and end-stage kidney disease in one each. Among 31 patients with CR, 22 (71.0 %) were receiving treatment with immunosuppressants at 5 years, including cyclosporine in 19, and seven of these 22 continued to show frequent relapse. Response to cyclosporine at 4 months predicted 5-year outcome in 31 of 35 patients.
CONCLUSIONS: Although SRNS treatment with cyclosporine provides high renal survival and remission rates, many children require ongoing immunosuppression. Management has advanced from the prevention of end-stage kidney disease to the long-term maintenance of remission and management of relapse after induction therapy.
Authors:
Yuko Hamasaki; Norishige Yoshikawa; Hitoshi Nakazato; Satoshi Sasaki; Kazumoto Iijima; Koichi Nakanishi; Takeshi Matsuyama; Kenji Ishikura; Shuichi Ito; Tetsuji Kaneko; Masataka Honda;
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2013-01-13
Journal Detail:
Title:  Pediatric nephrology (Berlin, Germany)     Volume:  28     ISSN:  1432-198X     ISO Abbreviation:  Pediatr. Nephrol.     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-03-21     Completed Date:  2013-09-16     Revised Date:  2014-03-21    
Medline Journal Info:
Nlm Unique ID:  8708728     Medline TA:  Pediatr Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  765-71     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Cyclosporine / adverse effects,  therapeutic use*
Disease Progression
Drug Therapy, Combination
Female
Follow-Up Studies
Glomerulosclerosis, Focal Segmental / complications,  diagnosis,  drug therapy*
Humans
Immunosuppressive Agents / adverse effects,  therapeutic use*
Japan
Kidney / drug effects*,  pathology
Kidney Failure, Chronic / etiology
Male
Methylprednisolone / therapeutic use
Nephrosis, Lipoid / complications,  diagnosis,  drug therapy*
Nephrotic Syndrome / complications,  congenital*,  diagnosis,  drug therapy
Prospective Studies
Recurrence
Remission Induction
Renal Insufficiency, Chronic / etiology
Time Factors
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 83HN0GTJ6D/Cyclosporine; X4W7ZR7023/Methylprednisolone
Comments/Corrections
Comment In:
Pediatr Nephrol. 2013 Oct;28(10):2065-6   [PMID:  23780471 ]

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


Previous Document:  Multigenerational effects of adolescent morphine exposure on dopamine D2 receptor function.
Next Document:  Preoperative plasma FGF23 levels predict acute kidney injury in children: results of a pilot study.