Comparison of cyclophosphamide and cyclosporine in the treatment of steroid-resistant idiopathic nephrotic syndrome in children.
- Author:
Jia RAO
1
;
Hong XU
;
Qi CAO
;
Wen-yan HUANG
;
Li-jun ZHOU
Author Information
1. Department of Pediatric Nephrology and Urology, Children's Hospital, Fudan University, Shanghai 200032, China.
- Publication Type:Journal Article
- MeSH:
Child;
Child, Preschool;
Cyclophosphamide;
therapeutic use;
Cyclosporine;
therapeutic use;
Female;
Humans;
Infant;
Male;
Nephrotic Syndrome;
congenital;
drug therapy;
Retrospective Studies;
Treatment Outcome
- From:
Journal of Central South University(Medical Sciences)
2007;32(6):958-963
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To compare the therapeutic outcome of cyclophosphamide(CTX) and cyclosporine A (CsA) in the treatment of steroid-resistant idiopathic nephrotic syndrome (SRNS) in children.
METHODS:Thirty-seven children with SRNS were analysed in a retrospective study from Jan 2001 to Dec. 2006. There was initial renal histology of minimal change (MCD) in 28 children, focal segmental glomerulosclerosis (FSGS) in 7 and mesangial proliferative glomerulonephritis (MsPGN) in the other 2. These patients were divided into 2 groups: one group received the induction therapy consisting of intravenous CTX and prednisolone, and the another group were treated with CsA [initial dose 3-5mg/(kg d)] and prednisolone.
RESULTS:(1) Thirty children received CTX, while 21 received CsA, and the total efficacy was 40.0% and 85.7% respectively after the 12 month follow-up. Children with MCD receiving CsA had a better response than those treated with CTX (93.8% vs 36.3%, P<0.05). Children with FSGS receiving CsA did not show a significant difference compared with those treated with CTX (75.0% vs 50.0%, P>0.05). (2) There were no significant associations between age, pathology, clinic type and therapeutic outcome in the 2 groups(P>0.05). (3)The rate of liver functional impairment, leukocytopenia, vomiting and nausea was 10%, 16.7% and 33.3%, respectively in children receiving CTX. The rate of hypertrichosis, gingival hyperplasia and hypertension was 71.4%, 23.8% and 9.5% respectively in children receiving CsA. Two children had central adverse effect. Two patients with FSGS progressed into end-stage renal failure.
CONCLUSION:For children with MCD, CsA combining prednisolone could result in a higher remission rate than intravenous CTX combining prednisolone.
