title: Kidney biopsy prior to cyclophosphamide therapy in primary nephrotic syndrome.
abstract: The study includes 30 children, 10 each with minimal change nephropathy (MCNS), diffuse mesangial proliferative glomerulonephritis (MesPGN) and focal segmental glomerulosclerosis (FSGS). Indications for kidney biopsy were: steroid resistance in 12 cases, and frequent relapses on maintenance steroid therapy in 18 cases. A 2-year remission was achieved by cyclophosphamide therapy in 6 patients with FSGS, 8 patients with MCNS and 8 patients with MesPGN. In terms of initial response to corticosteroids, only 3 of 8 patients with early steroid resistance responded to cyclophosphamide therapy compared with 3 of 4 with late steroid resistance and 16 of 18 with frequent relapses on maintenance steroid therapy. Response to cyclophosphamide therapy correlates better with the initial corticosteroid response than renal histopathology. A kidney biopsy prior to administration of cyclophosphamide is not essential in patients who respond to initial corticosteroid therapy.
authors.affiliation: Department of Paediatric Nephrology, Maternity and Children's Hospital, Riyadh, Saudi Arabia.
authors.forename: T K
authors.initials: TK
authors.lastname: Mattoo
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D007668:Kidney / Q000187:drug effects / Q000473:pathology*; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy / Q000473:pathology*
chemical_list: D003520:Cyclophosphamide