title: FK506 in the treatment of children with nephrotic syndrome of different pathological types.
abstract: OBJECTIVE
  To evaluate the efficacy of FK506 in the treatment of children with nephrotic syndrome of different underlying pathology.
  
  
  METHODS
  12 patients were treated with FK506 with a dosage of 0.1 - 0.15 mg/kg/d while corticosteroid dose was tapered stepwise. This therapeutic course lasted 3 - 6 months during which the plasma concentration ofFK506 was monitored.
  
  
  RESULTS
  12 children with different pathological types nephrotic syndrome were treated with FK506, including 4 cases of MCN, 6 cases of MsPGN, and 1 case of MPGN and 1 case of FSGS. After 2-month duration, 8 patients got complete remission including 4 cases of MCN and 4 cases of MsPGN and 3 children including 1 case of MsPGN, 1 case of MPGN, and 1 case of FSGS got partial remission. Only 1 child with MsPGN was considered to be a treatment failure. The overall response rate was 91.67% with the plasma concentration of FK506 maintained at 5 approximately 12 ng/ml, and the response time was 10 - 38 days. After 1-month duration, all patients except one experienced a reduction in proteinuria to normal levels or a partial response (50% reduction in protein excretion), significant increase in serum albumin, decrease in serum cholesterol and triglyceride and disappearance of edema. 2 months later, in 11 patients, blood biochemical values had returned to normal levels. The drug was generally well-tolerated. 3 patients had anorexia, nausea, vomiting. 2 patients experienced transient elevated serum creatinine which was reversible after the adjustment of dosage. 3 patients had minor changes in urine NAG. Only 2 of all patients relapsed.
  
  
  CONCLUSIONS
  FK506 is one of the effective immunosuppressants. In this study, FK506 in combination with a small doses of steroid while decreasing FK506 dosage plays a role in consolidating the curative effect and preventing relapse. In conclusion, FK506 may be effective in the treatment of nephrotic syndrome.
authors.affiliation: Department of Pediatrics, Jinling Hospital, Nanjing University School of Medicine, 305 East Road ZhongShan, Nanjing 210002, PR China. xzk@nzkidney.com
authors.forename: Z
authors.initials: Z
authors.lastname: Xia
authors.forename: G
authors.initials: G
authors.lastname: Liu
authors.forename: Y
authors.initials: Y
authors.lastname: Gao
authors.forename: Z
authors.initials: Z
authors.lastname: Fan
authors.forename: Y
authors.initials: Y
authors.lastname: Fu
authors.forename: L F
authors.initials: LF
authors.lastname: Zhang
authors.forename: X
authors.initials: X
authors.lastname: Ren
authors.forename: C
authors.initials: C
authors.lastname: Gao
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005260:Female; D015432:Glomerulonephritis, Membranoproliferative / Q000188:drug therapy / Q000503:physiopathology; D015433:Glomerulonephritis, Membranous / Q000188:drug therapy / Q000503:physiopathology; D005923:Glomerulosclerosis, Focal Segmental / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D007668:Kidney / Q000503:physiopathology; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D016559:Tacrolimus / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D016559:Tacrolimus