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Co-administration of cyclosporine and ketoconazole in idiopathic childhood nephrosis

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Abstract

The concomitant use of cyclosporine (CsA) and ketoconazole (keto) in children with nephrotic syndrome (NS) has never been reported in the literature. This retrospective cohort study was conducted to investigate cost saving, safety, and efficacy of co-administration of keto and CsA in children with NS. The study included 186 nephrotic children receiving CsA therapy. Most were steroid dependent or resistant, and the most common pathology was focal segmental glomerulosclerosis (62%). Among our patients, 137 received daily keto therapy (keto group) 50 mg/day in addition to CsA, while 49 received CsA alone (non-keto group). The characteristics of both groups were comparable and the mean (±SD) duration of treatment was 22.9 ± 8.1 months. Co-administration of keto significantly reduced the mean dose of CsA with an overall net cost saving of 37%. It also resulted in a significant improvement of CsA response, more successful steroid withdrawal, and decreased the frequency of renal impairment. Keto was generally well tolerated and safe. We conclude that co-administration of low-dose keto with CsA in children with idiopathic NS is safe, significantly reduces the cost of CsA therapy, and may improve the patient outcome.

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Authors and Affiliations

  1. Urology and Nephrology Center, Mansoura, Egypt

    Amr El-Husseini, Fathy El-Basuony, Ihab Mahmoud, Ahmed Donia, Nabil Hassan, Nagy Sayed-Ahmad & Mohamed Sobh

  2. Department of Nephrology, Urology and Nephrology Center, University of Mansoura, Egypt

    Mohamed Sobh

Authors
  1. Amr El-Husseini
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  2. Fathy El-Basuony
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  3. Ihab Mahmoud
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  4. Ahmed Donia
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  5. Nabil Hassan
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  6. Nagy Sayed-Ahmad
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  7. Mohamed Sobh
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Correspondence to Mohamed Sobh.

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El-Husseini, A., El-Basuony, F., Mahmoud, I. et al. Co-administration of cyclosporine and ketoconazole in idiopathic childhood nephrosis. Pediatr Nephrol 19, 976–981 (2004). https://doi.org/10.1007/s00467-004-1545-6

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  • DOI: https://doi.org/10.1007/s00467-004-1545-6

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