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Published on: November 8, 2015

Cyclosporine utilization in idiopathic nephrotic syndrome in children

Bassam Saeed1, Mohd Imad Ossman, Shaaban Sheriff

  • 1Pediatric Nephrology Department, Surgical Kidney Hospital, Ibn Alnafis Medical Complex, Damascus, Syria. bmsaeed2000@yahoo.com

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|December 26, 2006
PubMed

Insights

Cyclosporine A (CsA) effectively induces remission in children with steroid-dependent nephrotic syndrome (SDNS) and shows promise for steroid-resistant nephrotic syndrome (SRNS). This study highlights CsA as a valuable alternative therapy for pediatric nephrotic syndrome.

Area of Science:

  • Pediatric Nephrology
  • Immunosuppressive Therapy
  • Glomerular Diseases

Background:

  • Steroid-resistant focal segmental glomerulosclerosis (FSGS) presents a significant clinical challenge.
  • Cyclosporine A (CsA) is a primary treatment for steroid-resistant or steroid-dependent nephrotic children.

Purpose of the Study:

  • To review the clinical outcomes of children with idiopathic nephrotic syndrome (INS) treated with CsA.
  • To evaluate the efficacy of CsA in inducing remission in steroid-resistant (SRNS) versus steroid-dependent (SDNS) pediatric nephrotic syndrome.

Main Methods:

  • Retrospective review of 22 children with INS treated with CsA and alternate-day prednisolone.
  • Patients were categorized into SRNS (14) and SDNS (8) groups.
  • Renal histology included FSGS, minimal change disease (MCD), diffuse mesangial glomerulonephritis (MesGN), and membranous glomerulonephritis (MGN).

Main Results:

  • Overall remission (complete or partial) was achieved in 15 (68%) patients.
  • In the SRNS group, 7 (50%) patients responded to CsA, with 2 (14.2%) achieving complete remission.
  • In the SDNS group, 7 (87.5%) children achieved complete remission, and 1 (13.5%) had partial remission.

Conclusions:

  • CsA demonstrates higher efficacy in inducing remission in children with SDNS compared to SRNS.
  • CsA is a potentially effective alternative therapeutic option for pediatric nephrotic syndrome, particularly in steroid-dependent cases.

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