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1211 Cyclosporine a in the Treatment of Resistant Childhood Nephrotic Syndrome
  1. L Sfaihi,
  2. S Kmiha,
  3. I Maaloul,
  4. H Aloulou,
  5. I Chabchoub,
  6. T Kamoun,
  7. M Hachicha
  1. CHU Hedi Chaker, Sfax, Tunisia

Abstract

Background In children, idiopathic nephrotic syndrome is primarily treated using corticosteroids. When remission is not achieved, the administration of potent immunosuppressant therapy becomes imperative. Cyclosporine A (CsA) is reportedly associated with a higher incidence of remission in comparison with other immunosuppressive agents. The aim of our study is to evaluate the efficiency of cyclosporin A (CyA) therapy in 11 children treated with resistant nephrotic syndrome.

Methods Eleven children enrolled in this study were all hospitalized with resistant nephrotic syndrome, aged 1 to 11 years (average 5.8 yrs) and included 7 males and 4 females. CyA was given to each patient with dosage of 5 mg/kg/day during the corticosteroid was diminished. The renwal biopsy was performed in all patients before the administration of CyA.

Results Eleven children with resistant nephrotic syndrome of different pathological types were treated with CyA, including 3 cases of minimal change nephrotic syndrome (MCNS), 2 cases of mesangioproliferative glomerulonephritis (MsPGN), 1 case of extra membranous glomerulonephritis (EMGN) and 5 cases of focal segmental glomerular sclerosis (FSGS).

Three patients got complete remission, seven patients developed chronic renal insufficiency and one had no change after four month treatment with CyA. The overall response rate was 27%. Patients with different renal pathological types showed different responses. The FSGS cases showed the lowest rate.

Conclusion CyA has limited efficiency in patients with steroid-resistant nephrotic syndrome. CyA should be used cautiously because of the potential for CyA nephrotoxicity.

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