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01-05-2013 | Original Article

Prospective 5-year follow-up of cyclosporine treatment in children with steroid-resistant nephrosis

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

Published in: Pediatric Nephrology | Issue 5/2013

Abstract

Background

Cyclosporine has improved remission rates in children with steroid-resistant nephrotic syndrome (SRNS). However, little prospective long-term follow-up data is available.

Methods

We prospectively followed and analyzed 5-year outcomes of all 35 patients enrolled in our previous prospective multicenter trial with cyclosporine and steroids in children with SRNS. At enrollment, 23 cases were classified as minimal change (MC), five as diffuse mesangial proliferation (DMP), and seven as focal segmental glomerulosclerosis (FSGS).

Results

Renal survival at 5 years (median 7.7 years) was 94.3 %. Patient status was complete remission (CR) in 31 (88.6 %) (MC/DMP, 25; FSGS, 6); partial remission in one (FSGS); and non-remission in three (MC/DMP), including chronic kidney disease and end-stage kidney disease in one each. Among 31 patients with CR, 22 (71.0 %) were receiving treatment with immunosuppressants at 5 years, including cyclosporine in 19, and seven of these 22 continued to show frequent relapse. Response to cyclosporine at 4 months predicted 5-year outcome in 31 of 35 patients.

Conclusions

Although SRNS treatment with cyclosporine provides high renal survival and remission rates, many children require ongoing immunosuppression. Management has advanced from the prevention of end-stage kidney disease to the long-term maintenance of remission and management of relapse after induction therapy.

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Title: Prospective 5-year follow-up of cyclosporine treatment in children with steroid-resistant nephrosis
Authors: Yuko Hamasaki
Norishige Yoshikawa
Hitoshi Nakazato
Satoshi Sasaki
Kazumoto Iijima
Koichi Nakanishi
Takeshi Matsuyama
Kenji Ishikura
Shuichi Ito
Tetsuji Kaneko
Masataka Honda
for Japanese Study Group of Renal Disease in Children
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: Pediatric Nephrology / Issue 5/2013
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-012-2393-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prospective 5-year follow-up of cyclosporine treatment in children with steroid-resistant nephrosis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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