Treatment of focal segmental glomerulosclerosis.
The prognosis of untreated patients with focal segmental glomerulosclerosis is poor, as the disease progress to end-stage renal disease in approximately 50--70% of nephrotic patients. Although focal segmental glomerulosclerosis was initially considered to be a steroid-resistant disease, several studies have shown a better responsiveness to more prolonged courses of steroids. For patients with steroid-resistant or -dependent focal segmental glomerulosclerosis, cyclosporine A and cytotoxic agents have shown efficacy in clinical trials. Plasmapheresis or LDL-apheresis may represent a rescue treatment in patients who do not respond to other therapies. The role of other agents used in focal segmental glomerulosclerosis, including azathioprine, mycophenolate mofetil, tacrolimus, pefloxacin or vitamin E is still poorly defined.
Passerini
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Division of Nephrology and Dialysis, IRCCS, Maggiore Hospital, Milan, Italy. ponticel@polic.cilea.it
Ponticelli
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C
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001781:Blood Component Removal; D016572:Cyclosporine / Q000627:therapeutic use; D004351:Drug Resistance; D005923:Glomerulosclerosis, Focal Segmental / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D007163:Immunosorbent Techniques; D015366:Pefloxacin / Q000627:therapeutic use; D011687:Purines / Q000096:biosynthesis; D016559:Tacrolimus / Q000627:therapeutic use; D014810:Vitamin E / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000970:Antineoplastic Agents; D011687:Purines; D014810:Vitamin E; D015366:Pefloxacin; D016572:Cyclosporine; D016559:Tacrolimus