Ciclosporin in minimal-change glomerulopathy and in focal segmental glomerular sclerosis

Results of the available literature and preliminary data of an ongoing multicenter, prospective, randomized Italian trial indicate that ciclosporin (CS), at low doses, may maintain remission of the nephrotic syndrome in most steroid-sensitive patients. In steroid-resistant patients CS may cause either complete or partial remission in about 40% of patients with idiopathic nephrotic syndrome. With doses not exceeding 5 mg/kg/day and careful monitoring of renal and liver function, blood pressure and blood levels, severe side effects can be prevented. Although an extensive use of CS in nephrotic syndrome is still premature, cautious trials may be attempted in patients with steroid toxicity and/or devastating nephrotic syndrome.