Effects of Cyclosporin A Therapy Combined with Steroids and Angiotensin Converting Enzyme Inhibitors on Childhood IgA Nephropathy.
10.3346/jkms.2010.25.5.723
- Author:
Jae Il SHIN
1
;
Beom Jin LIM
;
Pyung Kil KIM
;
Jae Seung LEE
;
Hyeon Joo JEONG
;
Ji Hong KIM
Author Information
1. The Institute of Kidney Disease, Department of Pediatrics, Yonsei University College of Medicine, Severance Children's Hospital, Seoul, Korea. kkkjhd@yuhs.ac
- Publication Type:Clinical Trial ; Original Article
- Keywords:
Glomerulonephritis, IGA;
Cyclosporine;
Heavy Proteinuria;
Child
- MeSH:
Angiotensin-Converting Enzyme Inhibitors/*administration & dosage;
Child;
Cyclosporine/*administration & dosage;
Drug Combinations;
Female;
Glomerulonephritis, IGA/*diagnosis/*drug therapy;
Humans;
Immunosuppressive Agents/administration & dosage;
Male;
Steroids/*administration & dosage;
Treatment Outcome
- From:Journal of Korean Medical Science
2010;25(5):723-727
- CountryRepublic of Korea
- Language:English
-
Abstract:
To evaluate the effects of cyclosporin A (CyA) on clinical outcome and pathologic changes in children with IgA nephropathy (IgAN), we retrospectively evaluated 14 children (mean age 8.9+/-2.9 yr; eight males, six females) who were treated with CyA and steroids. The starting dose of CyA was 5 mg/kg per day, and the drug level was maintained at 100-200 ng/mL. The mean CyA level was 183.8+/-48.3 ng/mL (range 120.7-276.0 ng/mL) and the mean duration of CyA therapy was 10.9+/-1.9 months (range 8-12 months). After CyA therapy the mean 24 hr urinary protein excretion declined from 107.1+/-35.1 mg/m2/hr to 7.4+/-2.4 mg/m2/hr (P<0.001) and serum albumin increased from 3.3+/-0.6 g/dL to 4.3+/-0.3 g/dL (P<0.001). At a follow-up biopsy the histological grade of IgAN was improved in seven (50%) of the 14 patients, remained the same in three (21%), and was aggravated in four (29%). Serum creatinine, creatinine clearance, and blood pressure did not differ before and after CyA therapy. Two patients (14%) showed CyA-induced nephrotoxicity at the second biopsy. Our findings indicate that CyA therapy may be effective in reducing proteinuria and regressing renal pathology in a subset of children with IgAN.
