title: Treatment of steroid and cyclosporine-resistant idiopathic nephrotic syndrome in children.
abstract: Steroid-resistant nephrotic syndrome (SRNS) in children carries a significant risk of progression to end-stage renal failure (ESRF). We report a two-step protocol adapted in children with SRNS. Thirty-seven SRNS were treated with cyclosporine A (CyA) in association with prednisolone (alternate day) for 6 months (first-step treatment). Twelve patients (32.4%) went into complete remission, and 2 (5.4%) got partial remission. The other 23 cases who were steroid and CyA resistant entered a second-step treatment with withdrawing steroids, with CyA (5 mg/kg/day) in association with mycophenolate mofetil (MMF) 30 mg/kg/day for 6 months. Complete remission was observed in 11 cases (47.82%) and partial remission in 2 cases (8.7%). After two steps of treatment, 27/37 children went into total remission. In steroid and CyA-resistant INS, the association of MMF with CyA was able to induce remission in about half cases without relevant side effects.
authors.affiliation: Urology-Nephrology and Transplantation Research Centre, Department of Paediatric Nephrology, Urmia University School of Medicine, Iran.
authors.forename: A A
authors.initials: AA
authors.lastname: Nikibakhsh
authors.forename: H
authors.initials: H
authors.lastname: Mahmoodzadeh
authors.forename: M
authors.initials: M
authors.lastname: Karamyyar
authors.forename: S
authors.initials: S
authors.lastname: Hejazi
authors.forename: M
authors.initials: M
authors.lastname: Noroozi
authors.forename: A A
authors.initials: AA
authors.lastname: Macooie