Intravenous pulse cyclophosphamide--a new regime for steroid-resistant minimal change nephrotic syndrome.
The treatment of steroid-resistant minimal change nephrotic syndrome (MCNS) continues to pose a therapeutic challenge. We conducted a randomised prospective controlled trial to evaluate the efficacy of i.v. cyclophosphamide compared with oral cyclophosphamide in 13 children with biopsy-proven steroid-resistant MCNS. All 7 patients receiving i.v. cyclophosphamide achieved remission; this was sustained in 4 patients, while 3 relapsed. However, even these 3 patients subsequently became steroid sensitive. Of the 6 patients who received oral cyclophosphamide, 2 dropped out, 1 responded and 3 children continued to remain steroid resistant. The children who received IV cyclophosphamide had more sustained remissions, longer periods without proteinuria and fewer significant side effects; this was achieved at a lower cumulative dose.
Elhence
R
R
Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Gulati
S
S
Kher
V
V
Gupta
A
A
Sharma
R K
RK
D000284:Administration, Oral; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000008:administration & dosage* / Q000009:adverse effects; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D009402:Nephrosis, Lipoid / Q000188:drug therapy*; D011239:Prednisolone / Q000627:therapeutic use*; D011446:Prospective Studies; D011507:Proteinuria / Q000652:urine
D003520:Cyclophosphamide; D011239:Prednisolone