Prospective 5-year follow-up of cyclosporine treatment in children with steroid-resistant nephrosis View Full Text


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Article Info

DATE

2013-01-13

AUTHORS

Yuko Hamasaki, Norishige Yoshikawa, Hitoshi Nakazato, Satoshi Sasaki, Kazumoto Iijima, Koichi Nakanishi, Takeshi Matsuyama, Kenji Ishikura, Shuichi Ito, Tetsuji Kaneko, Masataka Honda, for Japanese Study Group of Renal Disease in Children

ABSTRACT

BackgroundCyclosporine has improved remission rates in children with steroid-resistant nephrotic syndrome (SRNS). However, little prospective long-term follow-up data is available.MethodsWe 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).ResultsRenal 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.ConclusionsAlthough 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. More... »

PAGES

765-771

References to SciGraph publications

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  • Journal

    TITLE

    Pediatric Nephrology

    ISSUE

    5

    VOLUME

    28

    Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00467-012-2393-4

    DOI

    http://dx.doi.org/10.1007/s00467-012-2393-4

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1020767792

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/23314441


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