The effect of treatment of corticosteroid-resistant idiopathic (primary) focal and segmental hyalinosis and sclerosis (focal glomerulosclerosis) with ciclosporin.
Nine patients with biopsy-proven primary focal and segmental hyalinosis and sclerosis (FSHS) and steroid-resistant nephrotic syndrome were randomly allocated to either a period of 4-6 months of treatment (ciclosporin; (CS); 5-8 mg/kg/24 h and warfarin) or to a control period (warfarin alone) and then crossed over to the alternative for a further 4-6 months. Serum creatinine levels increased at a similar rate during treatment and control periods of observation. Serum albumin levels increased (p less than 0.05) and urinary protein excretion decreased (p less than 0.01) in association with the CS therapy compared to the control period of observation. No patient had complete resolution of the nephrotic syndrome. In primary FSHS, CS treatment is unlikely to produce complete resolution of nephrotic-range proteinuria but does significantly decrease urinary protein excretion.
Walker
R G
RG
Department of Nephrology, Royal Melbourne Hospital, Victoria, Australia.
Kincaid-Smith
P
P
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000494:pharmacology; D000328:Adult; D003404:Creatinine / Q000097:blood; D003524:Cyclosporins / Q000009:adverse effects / Q000627:therapeutic use*; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D005921:Glomerulonephritis / Q000188:drug therapy*; D005923:Glomerulosclerosis, Focal Segmental / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000188:drug therapy / Q000503:physiopathology; D011507:Proteinuria / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic; D012709:Serum Albumin; D014859:Warfarin / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D003524:Cyclosporins; D012709:Serum Albumin; D014859:Warfarin; D003404:Creatinine