Morbidity in children with frequently relapsing nephrosis: 10-year follow-up of a randomized controlled trial View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-10-03

AUTHORS

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

ABSTRACT

BackgroundTo investigate the long-term outcome in children with frequently relapsing nephrotic syndrome (FRNS) we conducted a follow-up of a previous randomized controlled trial (RCT) 10 years after the initiation of the treatment protocol.MethodsWe previously conducted an RCT on the efficacy of cyclosporine for treating children with FRNS. After 2 years of treatment, a recommended a management protocol of steroids, and immunosuppressants was provided.ResultsValid information was available for 46 of the 56 patients (82.1 %) enrolled in the original RCT. The median follow-up period was 10.3 years from the start of protocol treatment with cyclosporine. At last follow-up (mean age 18.7 years), only ten patients (21.7 %) showed disease-free remission (no relapse for at least 2 years). In contrast, 23 (50.0 %) continued to relapse frequently or were on immunosuppressants, eight patients (17.4 %) had infrequent relapses without immunosuppressants. Adverse effects attributable to treatment included short stature (6 patients), osteoporosis (six patients), obesity (4 patients), cataracts (3 patients) and hypertension (3 patients). No lethal event or renal dysfunction occurred during follow-up.ConclusionsThis 10-year follow-up study shows that most children with FRNS experience relapses after 2 years of cyclosporine treatment, in adolescence and into adulthood. Outcomes in terms of life expectancy and renal function are favorable. More... »

PAGES

459-468

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00467-014-2955-8

DOI

http://dx.doi.org/10.1007/s00467-014-2955-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1035186479

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25277597


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