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Montelukast as an add-on treatment in steroid dependant nephrotic syndrome, randomised-controlled trial

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Abstract

Background

The underlying mechanisms of nephrotic syndrome (NS) are still under debate and the need for more effective and less toxic treatment is challenging. We aimed to evaluate the efficacy of montelukast, a leukotriene receptor antagonist as an add-on therapy, and to explore the leukotriene (LT) biology in steroid-dependent nephrotic syndrome (SDNS).

Methods

A randomized controlled trial was conducted including 32 patients with SDNS who were randomly assigned to receive standard steroid treatment only [low-dose steroid (LDS) group] or standard steroid therapy plus montelukast (Montelukast group). Urine protein/creatinine ratio, serum albumin, creatinine, cholesterol, and plasma LTs (LTB4/C4/D4/E4) were evaluated in all patients before and after treatment.

Results

After treatment, both groups showed a significant decrease of LTB4 and LTC4/D4/E4. Further, the Montelukast group showed a significant decrease in serum creatinine and a significant increase in diastolic blood pressure and protein/creatinine ratio. It also showed a marked decrease in plasma LTC4/D4/E4 compared to the LDS group, although not statistically significant.

Conclusions

Our findings highlight the effect of montelukast on renal function, but suggest that the clinical and laboratory efficacy of the addition of montelukast to steroids in maintenance treatment of SDNS is debatable.

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Authors and Affiliations

  1. Faculty of Medicine, Allergy, Respiratory and Clinical Immunology Unit, Pediatric Department, Mansoura University, Mansoura, Egypt

    Magdy Mohamed Zedan & Amal Osman

  2. Faculty of Medicine, Nephrology Unit, Pediatric Department, Mansoura University, Mansoura, Egypt

    Ahmed El-Refaey & Mohamed M. Zedan

  3. Faculty of Medicine, Clinical Pathology Department, Mansoura University, Mansoura, Egypt

    Hosam Zaghloul

  4. Faculty of Pharmacy, Clinical Pharmacy Department, BeniSuef University, Benisuef, Egypt

    Mohamed E. A. Abdelrahim & Nashwa Eltantawy

Authors
  1. Magdy Mohamed Zedan
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  2. Ahmed El-Refaey
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  3. Hosam Zaghloul
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  4. Mohamed E. A. Abdelrahim
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  5. Amal Osman
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  6. Mohamed M. Zedan
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  7. Nashwa Eltantawy
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Correspondence to Magdy Mohamed Zedan.

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Funding

This study was not funded.

Conflict of interest

The authors declared that they have no conflict of interests.

Ethical statement

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Zedan, M.M., El-Refaey, A., Zaghloul, H. et al. Montelukast as an add-on treatment in steroid dependant nephrotic syndrome, randomised-controlled trial. J Nephrol 29, 585–592 (2016). https://doi.org/10.1007/s40620-016-0297-2

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  • DOI: https://doi.org/10.1007/s40620-016-0297-2

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