[Cyclosporin A versus cyclophosphamide in the treatment of nephrotic syndrome in children].
BACKGROUND
The majority of cases of nephrotic syndrome in children is corticosensitive, however in some individuals aggressive cytotoxic therapy is necessary. Cyclosporin A and cyclophosphamide are widely used; however their relative effectiveness in maintaining remission of childhood nephrotic syndrome remains controversial.


RESULTS
Effectiveness of long-term cytotoxic therapy (mean follow-up 7.4 years) in 63 children (mean age 6.19 +/- 4.30 years) with nephrotic syndrome was retrospectively analyzed; 14 patients suffered from corticosensitive, 33 from corticodependent and 16 from corticoresistant nephrotic syndrome. Corticotherapy alone was used in 15 patients (23.8%), cyclophosphamide was added in 27 (42.9%) and cyclosporin A in 38 cases (60.3%), while 17 patients (27%) were on both immunosuppressive agents. 84% children relapsed within 24 months after cessation of cyclosporin A. In 8 corticoresistant nephrotic syndrome patients (61.5%) from 13 children treated with cyclosporin A no remission occurred, in 5 children (38.5%) was remission obtained within 10 weeks, however in 4 of them relapsed disease during cyclosporin A therapy. 19 (70.4%) of 27 patients on cyclophosphamide therapy were in remission, in 8 of them (42.1%) even 2 years after cyclophosphamide therapy.


CONCLUSIONS
Cyclophosphamide therapy of childhood nephrotic syndrome is more effective in maintaining long-term remission than cyclosporin A treatment.
Podracká
L
L
Klinika detí a dorastu LF UPJS, Kosice, Slovenská republika. podracka@lf.upjs.sk
Böör
A
A
Sasinka
M
M
D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000627:therapeutic use*; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D012074:Remission Induction
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003520:Cyclophosphamide