title: [Treatment of idiopathic nephrotic syndrome with cyclosporin A].
abstract: OBJECTIVE
  Cyclosporin A (CyA) has been used in steroid-dependent and steroid-resistant nephrotic syndrome (NS) with the aim to prolong or to induce remission, respectively.
  
  
  METHODS
  The efficacy and side-effects of CyA therapy were evaluated in 25 children with idiopathic NS. Twelve patients had steroid-dependent NS and 13 patients had steroid-resistant NS. In all cases, CyA was given as a third alternative drug, once therapies with prednisone and alkylating agents had failed. In steroid-resistant patients CyA administration was always associated with low-dose prednisone.
  
  
  RESULTS
  All 12 patients with steroid-dependent NS entered into remission during CyA administration, but 7 patients relapsed when the drug was withdrawn or tapered and 7 of 8 patients requiring long-term therapy continued to present new relapses. Prednisone requirement was lower and growth velocity higher during the year on CyA therapy than during the year preceding CyA therapy. Only 5 of the 13 patients with steroid-resistant NS had a complete remission. Three of these patients relapsed upon cessation of therapy, but these relapses became steroid-sensitive. Clinical side-effects (hirsutism, gum hyperplasia, arterial hypertension) were only observed in a few patients. Biochemical side-effects (hyperuricemia, hypomagnesemia) were more frequently observed, but always reverted upon cessation of therapy. The development of osteosarcoma in one patient may represent a coincidental finding.
  
  
  CONCLUSIONS
  The results suggest that CyA therapy is capable of inducing remission in all patients with steroid-dependent NS and in about one third of patients with steroid-resistant NS. However, most patients relapse when the CyA is stopped and require long-term therapy, often associated with administration of predisone.
authors.affiliation: Departamento de Pediatría, Hospital de Cruces y Facultad de Medicina de la Universidad del País Vasco, España.
authors.forename: G
authors.initials: G
authors.lastname: Ariceta Iraola
authors.forename: J
authors.initials: J
authors.lastname: Rodríguez Soriano
authors.forename: A
authors.initials: A
authors.lastname: Vallo Boado
authors.forename: M J
authors.initials: MJ
authors.lastname: Quintela Pérez
authors.forename: R
authors.initials: R
authors.lastname: Oliveros Pérez
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016572:Cyclosporine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D011241:Prednisone / Q000627:therapeutic use; D012075:Remission, Spontaneous; D012189:Retrospective Studies
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D016572:Cyclosporine; D011241:Prednisone
vernacular_title: Tratamiento del síndrome nefrótico idiopático con ciclosporina A.