Abstract.
Patients with steroid-resistant focal and segmental glomerulosclerosis (FSGS) have a poor prognosis but may benefit from high-dose methylprednisolone or cyclosporine A therapy. Ten patients were treated with a protocol of methylprednisolone infusions for 8 weeks followed by a combination of cyclosporine A and alternate-day prednisone for maintenance of remission for 2 weeks. Eight of ten patients remitted the nephrotic syndrome within 8 weeks of beginning treatment. One patient remitted edema but remained proteinuric, and one did not respond. After observation for 12 – 24 months, seven patients maintained remission with normal glomerular filtration rate. One non-responder had renal insufficiency and one patient had secondary non-response and end-stage renal disease. No patients developed hypertension. One patient had the diagnosis of Hodgkin disease made after 10 months of therapy. Follow-up renal biopsy in four patients showed no evidence of progressive interstitial disease. There were no other major side effects. Steroid-resistant FSGS may be successfully treated with the described protocol. Additional studies will be needed to determine if this approach prevents progression of renal disease.
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Received October 2, 1997; received in revised form January 23, 1998; accepted January 25, 1998
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Waldo, F., Benfield, M. & Kohaut, E. Therapy of focal and segmental glomerulosclerosis with methylprednisolone, cyclosporine A, and prednisone. Pediatr Nephrol 12, 397–400 (1998). https://doi.org/10.1007/s004670050473
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DOI: https://doi.org/10.1007/s004670050473