Effectiveness and Safety of Cyclosporine A in Childhood Nephrotic Syndrome.

Document Type : Original Article

Authors

1 Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt.

2 Department of Pediatrics, Faculty of Medicine, Jouf University, Saudi Arabia.

Abstract

Introduction: Cyclosporine A is a calcineurin inhibitor used as an important of line therapy in children with steroid-resistant nephrotic syndrome (SRNS) and as a steroid-sparing agent for children with steroid-dependent nephrotic syndrome (SDNS).However, limited data about its efficacy and side effects in children warrants further evaluation.
Methods: In this study, fifty children (who started cyclosporine A drug as a part of their management plan) were included. They were divided into two subgroups, SDNS (29 cases) and SRNS (21cases). Primary end points of the study were to analyze percentage of remission in both groups. In addition, prevelance of cyclosporine side effects were recorded. 
Results: At the end of the 4th month of cyclosporine therapy, 76.2% of patients of SRNS achieved complete remission. At the end of 12th month, 85.7% of patients achieved complete remission and 14.3 %   of them achieved partial remission. In the steroid dependent group, the mean number of relapses over one year was decreased by a percentage of 82.6% after starting cyclosporine treatment. 
Conclusion: It was concluded that Cyclosporine A is safe and effective to be used in children with steroid resistant nephrotic syndrome. In steroid dependent children, it can be used as a steroid sparing drug reducing the dose of steroid. However, safety of cyclosporine a drug is not absolute, variable degrees of side effects were reported
 

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