[Immunosuppressive therapy for nephrotic syndrome and strategy for adverse side effects from that therapy]

The nephrotic syndrome is commonly caused by various glomerulonephritides, i.e. minimal change nephrotic syndrome, focal segmental glomerulosclerosis and membranous nephropathy. A long term corticosteroid therapy is a first therapeutic approach for patients with nephrotic syndrome. In patients who have contraindication to steroids or in those who do not respond to steroids, immunosuppressive agents such as cyclosporine, mizoribine, azathioprine and cyclophosphamide are the next therapeutic approach for inducing the remission of the nephrotic syndrome. In this review, we described an appropriate use of systemic immunosuppressive agents for steroid resistant nephrotic syndrome, and the toxicity and side effects of each agent. And currently the clinical trials with new immunosuppressants like tacrolimus (FK 506) and mycophenolate mofetil are also described.