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01-03-2015 | Original Article

Morbidity in children with frequently relapsing nephrosis: 10-year follow-up of a randomized controlled trial

Authors: Kenji Ishikura, Norishige Yoshikawa, Hitoshi Nakazato, Satoshi Sasaki, Koichi Nakanishi, Takeshi Matsuyama, Shuichi Ito, Yuko Hamasaki, Nahoko Yata, Takashi Ando, Kazumoto Iijima, Masataka Honda, for Japanese Study Group of Renal Disease in Children

Published in: Pediatric Nephrology | Issue 3/2015

Abstract

Background

To investigate the long-term outcome in children with frequently relapsing nephrotic syndrome (FRNS) we conducted a follow-up of a previous randomized controlled trial (RCT) 10 years after the initiation of the treatment protocol.

Methods

We previously conducted an RCT on the efficacy of cyclosporine for treating children with FRNS. After 2 years of treatment, a recommended a management protocol of steroids, and immunosuppressants was provided.

Results

Valid information was available for 46 of the 56 patients (82.1 %) enrolled in the original RCT. The median follow-up period was 10.3 years from the start of protocol treatment with cyclosporine. At last follow-up (mean age 18.7 years), only ten patients (21.7 %) showed disease-free remission (no relapse for at least 2 years). In contrast, 23 (50.0 %) continued to relapse frequently or were on immunosuppressants, eight patients (17.4 %) had infrequent relapses without immunosuppressants. Adverse effects attributable to treatment included short stature (6 patients), osteoporosis (six patients), obesity (4 patients), cataracts (3 patients) and hypertension (3 patients). No lethal event or renal dysfunction occurred during follow-up.

Conclusions

This 10-year follow-up study shows that most children with FRNS experience relapses after 2 years of cyclosporine treatment, in adolescence and into adulthood. Outcomes in terms of life expectancy and renal function are favorable.

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Title: Morbidity in children with frequently relapsing nephrosis: 10-year follow-up of a randomized controlled trial
Authors: Kenji Ishikura
Norishige Yoshikawa
Hitoshi Nakazato
Satoshi Sasaki
Koichi Nakanishi
Takeshi Matsuyama
Shuichi Ito
Yuko Hamasaki
Nahoko Yata
Takashi Ando
Kazumoto Iijima
Masataka Honda
for Japanese Study Group of Renal Disease in Children
Publication date: 01-03-2015
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 3/2015
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-014-2955-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Morbidity in children with frequently relapsing nephrosis: 10-year follow-up of a randomized controlled trial

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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