Pediatric Nephrology

, Volume 7, Issue 3, pp 249–252 | Cite as

Long-term ciclosporin treatment in children with steroid-dependent nephrotic syndrome

  • Ryojiro Tanaka
  • Norishige Yoshikawa
  • Yoshitaka Kitano
  • Hiroshi Ito
  • Hajime Nakamura
Original Article

Abstract

We report the effect of 18-month ciclosporin (CS) treatment in 19 children with steroid-dependent frequently relapsing nephrotic syndrome. CS was started at 3–5 mg/kg per day after remission with steroid therapy, was adjusted to maintain a trough blood level of between 200 and 600 ng/ml and was administered for 6 months (high-dose CS). Then, the dosage of CS was decreased and 2.5 mg/kg per day was administered for the subsequent 12 months (low-dose CS). Only 2 patients had relapses during the initial 6 months of CS therapy. Eight patients had infrequent relapses, 4 had frequent relapses and 7 had no relapses during the 12 months of low-dose CS. Not only did continuation of CS at a lower dosage decrease the relapse rate, it also reduced steroid toxicity, allowed increased growth in 16 of the 19 patients and also decreased obesity scores in 12 of these patients. All of the side-effects that occurred during the 18-month period of CS treatment were reversible and none was serious enough to necessitate discontinuation of therapy. Our 18-month CS treatment was helpful in preventing relapses and reducing steroid toxicity in children with steroid-dependent frequently relapsing nephrotic syndrome.

Key words

Ciclosporin Steroid-dependent nephrotic syndrome Growth Obesity Steroid toxicity 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Hoyer PF, Krull F, Brodehl J (1986) Cyclosporin in frequently relapsing minimal change nephrotic syndrome. Lancet II: 335Google Scholar
  2. 2.
    Capodicasa G, De Santo NG, Nuzzi F, Giordano C (1986) Cyclosporin A in nephrotic syndrome of childhood—a 14 month experience. Int J Pediatr Nephrol 7: 69–72PubMedGoogle Scholar
  3. 3.
    Niaudet P, Tete MJ, Broyer M, Habib R (1988) Cyclosporine and childhood idiopathic nephrosis. Transplant Proc 20: 265–268PubMedGoogle Scholar
  4. 4.
    Brodehl J, Hoyer PF, Oemar BS, Helmchen U, Wonigeit K (1988) Cyclosporine treatment of nephrotic syndrome in children. Transplant Proc 20: 269–274Google Scholar
  5. 5.
    Tejani A, Butt K, Trachtman H, Suthanthiran M, Rosenthal CJ, Khawar MR (1988) Cyclosporine A induced remission of relapsing nephrotic syndrome in children. Kidney Int 33: 729–734PubMedGoogle Scholar
  6. 6.
    Brandis M, Burghard R, Leititis J, Zimmerhockl B, Hildebrandt F, Helmchen U (1988) Cyclosporine A for treatment of nephrotic syndromes. Transplant Proc 20: 275–279PubMedGoogle Scholar
  7. 7.
    Kitano Y, Yoshikawa N, Tanaka R, Nakamura H, Ninomiya M, Ito H (1990) Ciclosporin treatment in children with steroid-dependent nephrotic syndrome. Pediatr Nephrol 4: 474–477PubMedGoogle Scholar
  8. 8.
    International Study of Kidney Disease in Children (1982) Early identification of frequent relapsers among children with minimal change nephrotic syndrome. J Pediatr 101: 514–518Google Scholar
  9. 9.
    International Study of Kidney Disease in children (1981) Primary nephrotic syndrome in children: clinical significance of histopathologic variants of minimal change and of diffuse mesangial hyper-cellularity. Kidney Int 20: 765–771Google Scholar
  10. 10.
    Garin EH, Pryor ND, Fennell RS, Richard GA (1978) Pattern of response to prednisone in idiopathic, minimal lesion nephrotic syndrome as a criterion in selecting patients for cyclophosphamide therapy. J Pediatr 92: 304–308PubMedGoogle Scholar
  11. 11.
    Arbeitsgemeinschaft für Pädiatrische Nephrologie (1982) Effect of cytotoxic drugs in frequently relapsing nephrotic syndrome with and without steroid dependence. N Engl J Med 306: 451–454Google Scholar
  12. 12.
    Arbeitsgemeinschaft für Pädiatrische Nephrologie (1987) Cyclophosphamide treatment of steroid dependent nephrotic syndrome: comparison of eight week with 12 week course. Arch Dis Child 62: 1102–1106Google Scholar
  13. 13.
    Niaudet P (1992) The French Society of Paediatric Nephrology: comparison of cyclosporin and chlorambucil in the treatment of steroid-dependent idiopathic nephrotic syndrome: a multicentre randomized controlled trial. Pediatr Nephrol 6: 1–3PubMedGoogle Scholar

Copyright information

© IPNA 1993

Authors and Affiliations

  • Ryojiro Tanaka
    • 1
  • Norishige Yoshikawa
    • 1
  • Yoshitaka Kitano
    • 1
  • Hiroshi Ito
    • 2
  • Hajime Nakamura
    • 1
  1. 1.Department of PediatricsKobe University HospitalKobeJapan
  2. 2.Department of PaediatricsTokyo Metropolitan Children's HospitalTokyoJapan

Personalised recommendations