Home About us Current issue Back issues Submission Instructions Advertise Contact Login   

Search Article 
  
Advanced search 
 
Saudi Journal of Kidney Diseases and Transplantation
Users online: 1993 Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size 


 
ORIGINAL ARTICLE Table of Contents   
Year : 2010  |  Volume : 21  |  Issue : 3  |  Page : 484-487
Treatment of steroid resistant nephrotic syndrome in children


1 Department of Pediatrics, King Abdul Aziz University Hospital, Jeddah, Saudi Arabia
2 Department of Histopathology, King Abdul Aziz University Hospital, Jeddah, Saudi Arabia

Correspondence Address:
Jameela A Kari
Pediatrics Department, King Abdul Aziz University Hospital, P.O. Box 80215, Jeddah 21589
Saudi Arabia
Login to access the Email id


PMID: 20427873

Rights and Permissions

Achieving remission in children with Steroid-Resistant Nephrotic Syndrome (SRNS) could be difficult. Many immunosuppressive drugs are used with variable success rates. We have studied the response of children with SRNS who presented to our pediatric's renal unit between 2002 and 2007 to various modalities of therapy. We included patients with no response to pred­nisolone (60 mg/M 2 /day) after four weeks of therapy; all the patients had renal biopsy and follow­up duration for at least one year. We excluded patients with congenital nephrotic syndrome, lupus, or sickle cell disease. There were 31 (23 girls and 8 boys with F: M= 2.9:1; the mean age at presentation was 4.2 ± 3.2) children who fulfilled the inclusion criteria. The mean duration of follow up was 3.1 ± 1.6 years. Twenty children (65%) achieved partial (6 children) or complete (14 children) remission. There were 16 children treated with cyclophosphamide either oral or intra­venous, and only 4 of them (25%) achieved remission. Seven children received oral chlorambucil, and only2 of them (28.5%) achieved remission; none of the children experienced side effects. Fifteen children received cyclosporine, and only eight of them (53%) achieved remission. Six children developed gum hypertrophy and one had renal impairment, which was reversible after discontinuing the drug. Mycophonelate mofetil (MMF) was used as the last option in 5 children, and 2 of them achieved complete remission. One child developed a systemic cytomegalovirus (CMV) infection which indicated discontinuing the drug. Fourteen (45%) children needed more than one immunosuppressive therapy. Three children progressed to end stage renal failure and required dialysis. We conclude that SRNS in children is a difficult disease with significant morbidity. However, remission is achievable with cyclosporine and other immunosuppressive agents. Treatment should be individualized according to the underlying histopathology, and clinical and social conditions of the children.


[FULL TEXT] [PDF]*
Print this article  Email this article
    

  Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
   Citation Manager
  Access Statistics
   Reader Comments
   Email Alert *
   Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed5700    
    Printed103    
    Emailed0    
    PDF Downloaded1557    
    Comments [Add]    
    Cited by others 4    

Recommend this journal