title: Combined cyclosporine and prednisolone therapy in adult patients with the first relapse of minimal-change nephrotic syndrome.
abstract: BACKGROUND
  Although minimal-change nephrotic syndrome (MCNS) is highly steroid-responsive, some patients show frequent relapses, necessitating administration of repeated courses of prednisolone (PSL) at high doses. The adverse effects of long-term PSL treatment include osteoporosis, infection, diabetes, cataract, etc., most of which are serious. It is therefore necessary to establish useful strategies to reduce the PSL dose.
  
  
  METHODS
  Patients with the first relapse of MCNS were randomly assigned to two groups, namely, the CyA (AUC 1700-2000 ng/ml) + PSL (0.8 mg/kg/day) group (n = 26) and the PSL alone (PSL) (1.0 mg/kg/day) group (n = 26), and the clinical characteristics were compared between the two groups. All patients used C2 for CyA monitoring.
  
  
  RESULTS
  A significant decrease of the urinary protein excretion (P = 0.02) and serum total cholesterol (P = 0.003) was observed at 2 weeks from the first relapse in the CyA + PSL group. The increase in the serum total protein (P = 0.03) and serum albumin (P = 0.007) as compared with that in the PSL group was also observed in the CyA + PSL group at this time-point. The time to remission in the CyA + PSL group was shorter than that in the PSL group (P = 0.006).
  
  
  CONCLUSIONS
  It was possible to obtain early remission and reduce the PSL dose with combined CyA and PSL therapy in patients with MCNS.
authors.affiliation: Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Eguchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Takei
authors.forename: Takumi
authors.initials: T
authors.lastname: Yoshida
authors.forename: Ken
authors.initials: K
authors.lastname: Tsuchiya
authors.forename: Kosaku
authors.initials: K
authors.lastname: Nitta
mesh_terms: D000328:Adult; D002784:Cholesterol / Q000097:blood; D016572:Cyclosporine / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D009402:Nephrosis, Lipoid / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use*; D011507:Proteinuria / Q000378:metabolism; D012008:Recurrence; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D002784:Cholesterol; D011239:Prednisolone