Abstract
Thirty-five children (12 girls, 23 boys), aged from 1 year and 5 months to 14 years at the onset of idiopathic nephrotic syndrome, received cyclosporin A (CyA) because of steroid toxicity or failure to respond to steroids. The initial oral dose was 6 mg/kg per day and this was adjusted to obtain trough plasma levels of 50–150 ng/ml. The duration of treatment was between 2 and 8 months. In patients who responded to CyA treatment, the dosage was tapered off; treatment was stopped if found to be ineffective. Of the 35 children, 20 were frequent-relapsing steroid responders who suffered serious side-effects from steroid therapy. Seventeen of them either went into remission or did not relapse despite the withdrawal of prednisone. Prednisone doses could be lowered but not stopped in 1 patient and the remaining 2 patients relapsed when prednisone was tapered off. At the final examination, 10 of the 12 children in whom CyA was tapered off and who had initially responded to CyA had relapsed. A second course was given to these 10 patients and 3 failed to respond. Five children were partial steroid responders and CyA induced a remission in 1 and a partial remission in another. Among the 10 children who were steroid resistant, only 1 responded to CyA, 2 had a partial response and 7 failed to respond to CyA. A reduction of glomerular filtration rate occurred in 8 patients, 7 of whom had either persistent nephrotic syndrome or were in relapse, which suggests that factors other than CyA nephrotoxicity may have been operative. Complete reversal occurred in only 4 patients. Significant histological changes, likely to be related to CyA, were seen in 2 repeat renal biopsies out of the 11 performed.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Tejani A, Butt K, Khawar R, Suthabthuran M, Rosenthal CJ, Tachtman H, Fusi M (1985) Cyclosporine (Cy) induced remission of relapsing nephrotic syndrome (RNS) in children. Kidney Int 29: 206
Meyrier A, Simon P, Perret GF, Condamin-Meyrier MC (1986) Remission of idiopathic nephrotic syndrome after treatment with Cyclosporine A. Br Med J 292: 789–792
Hoyer PF, Krull F, Brodehl J (1986) Cyclosporin in frequently relapsing minimal change nephrotic syndrome. Lancet II: 335
Capodicasa G, De Santo NG, Nuzzi F, Giordano C (1986) Cyclosporine A in nephrotic syndrome of childhood. A 14 month experience. Int J Pediatr Nephrol 7: 69–72
Brandis M, Burghard R, Leititis J, Zimerhackl B, Hildbrandt F, Helmchen U (1987) Cyclosporin A for treatment in nephrotic syndrome. Pediatr Nephrol 1: C42
Lokiec F, Devergie A, Poirier O, Gluckman E (1983) Pharmacologic monitoring in the clinical use of Cyclosporine. Transplant Proc 15: S 226–229
Habib R, Churg J (1984) Minimal change disease, measangial proliferation glomerulonephritis and focal sclerosis: individual entities or a spectrum of disease. In: Robinson RR (ed) Nephrology. Springer, Berlin Heidelberg New York, pp 634–644
Palestine AG, Austin HA, Balow JE, Antonovycht T, Sabnis SG, Preuss HG, Nussenblatt RB (1986) Renal histopathologic alterations in patients treated with Cyclosporine for uveitis. N Engl J Med 314:1293–1298
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Niaudet, P., Habib, R., Tete, MJ. et al. Cyclosporin in the treatment of idiopathic nephrotic syndrome in children. Pediatr Nephrol 1, 566–573 (1987). https://doi.org/10.1007/BF00853590
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00853590