title: Renal function and proteinuria after successful immunosuppressive therapies in patients with FSGS.
abstract: OBJECTIVE
  In the FSGS Clinical Trial, 22 cyclosporine-treated and 20 mycophenolate/dexamethasone-treated patients experienced a complete or partial remission after 26 weeks, completed 52 weeks of treatment, and were studied through 78 weeks. Herein, changes in the urine protein/creatinine ratio (UP/C) and estimated GFR (eGFR) throughout the entire study period are defined.
  
  
  METHODS
  The FSGS Clinical Trial, which was conducted from November 2004 to January 2010, enrolled patients aged 2-40 years, with eGFR ≥40 ml/min per 1.73 m(2) and UP/C >1 mg/mg after ≥4 weeks of corticosteroid therapy. Both groups received lisinopril or losartan throughout the study. UP/C and eGFR were measured at 0, 26, 52, and 78 weeks.
  
  
  RESULTS
  The median UP/C in the cyclosporine- and mycophenolate/dexamethasone-responsive patients fell by 89.8% and 82.7% at 52 weeks; the fall was largely sustained at 78 weeks (74.7% and 80.3%, respectively). The mean eGFR fell by 19.4% in the cyclosporine group and rose by 7.0% in the mycophenolate mofetil/dexamethasone group at 52 weeks, but subsequently rose by 16.4% and fell by 2.6%, respectively, in the two groups from 52 to 78 weeks.
  
  
  CONCLUSIONS
  In this subset of responding FSGS patients, the improvement in UP/C after cyclosporine or mycophenolate/dexamethasone treatment was largely sustained for 6 months after therapy. Reduction in eGFR in the cyclosporine group was improved 6 months after cyclosporine was stopped although the levels were lower than baseline in seven patients who entered the study with decreased eGFR.
authors.affiliation: Pediatric Nephrology, Scott & White Healthcare, Temple, TX 76508, USA. RHOGG@swmail.sw.org
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Hogg
authors.forename: Aaron
authors.initials: A
authors.lastname: Friedman
authors.forename: Tom
authors.initials: T
authors.lastname: Greene
authors.forename: Milena
authors.initials: M
authors.lastname: Radeva
authors.forename: Milos N
authors.initials: MN
authors.lastname: Budisavljevic
authors.forename: Jennifer
authors.initials: J
authors.lastname: Gassman
authors.forename: Debbie S
authors.initials: DS
authors.lastname: Gipson
authors.forename: J Ashley
authors.initials: JA
authors.lastname: Jefferson
authors.forename: Eunice G
authors.initials: EG
authors.lastname: John
authors.forename: Frederick J
authors.initials: FJ
authors.lastname: Kaskel
authors.forename: Asha
authors.initials: A
authors.lastname: Moudgil
authors.forename: Marva
authors.initials: M
authors.lastname: Moxey-Mims
authors.forename: Luis A
authors.initials: LA
authors.lastname: Ortiz
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Schelling
authors.forename: William
authors.initials: W
authors.lastname: Schnaper
authors.forename: Tarak
authors.initials: T
authors.lastname: Srivastava
authors.forename: Howard
authors.initials: H
authors.lastname: Trachtman
authors.forename: V Matti
authors.initials: VM
authors.lastname: Vehaskari
authors.forename: Craig
authors.initials: C
authors.lastname: Wong
authors.forename: Robert P
authors.initials: RP
authors.lastname: Woronieki
authors.forename: Scott K
authors.initials: SK
authors.lastname: Van Why
authors.forename: Anna
authors.initials: A
authors.lastname: Zolotnitskaya
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000188:drug therapy* / Q000503:physiopathology* / Q000652:urine; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007677:Kidney Function Tests; D008297:Male; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011446:Prospective Studies; D011507:Proteinuria / Q000652:urine; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D003907:Dexamethasone; D016572:Cyclosporine; D009173:Mycophenolic Acid