A new therapeutic approach of nephrotic syndrome associated with focal segmental glomerulosclerosis

Nine cases of nephrotic children associated with focal segmental glomerulosclerosis who had failed to respond to prednisone and cyclophosphamide therapy and showed sign of progressive deterioration of renal function, were subjected to the therapeutic combinations of antiplatelet agents + prednisone +/- anticoagulant agents. Initially, all were hypertensive, 77.8% had creatinine clearance of less than 60 ml/min/1.73 m2 and associated infections were documented in eight of nine cases. With therapy, improvement in clinical status as well as renal function and platelet kinetics were substantiated in all of the studied cases. Thus, this mode of therapy appears to be beneficial in these nephrotic children in whom associated infection is a potentially threatening factor.