title: Morbidity in children with frequently relapsing nephrosis: 10-year follow-up of a randomized controlled trial.
abstract: BACKGROUND
  To investigate the long-term outcome in children with frequently relapsing nephrotic syndrome (FRNS) we conducted a follow-up of a previous randomized controlled trial (RCT) 10 years after the initiation of the treatment protocol.
  
  
  METHODS
  We previously conducted an RCT on the efficacy of cyclosporine for treating children with FRNS. After 2 years of treatment, a recommended a management protocol of steroids, and immunosuppressants was provided.
  
  
  RESULTS
  Valid information was available for 46 of the 56 patients (82.1 %) enrolled in the original RCT. The median follow-up period was 10.3 years from the start of protocol treatment with cyclosporine. At last follow-up (mean age 18.7 years), only ten patients (21.7 %) showed disease-free remission (no relapse for at least 2 years). In contrast, 23 (50.0 %) continued to relapse frequently or were on immunosuppressants, eight patients (17.4 %) had infrequent relapses without immunosuppressants. Adverse effects attributable to treatment included short stature (6 patients), osteoporosis (six patients), obesity (4 patients), cataracts (3 patients) and hypertension (3 patients). No lethal event or renal dysfunction occurred during follow-up.
  
  
  CONCLUSIONS
  This 10-year follow-up study shows that most children with FRNS experience relapses after 2 years of cyclosporine treatment, in adolescence and into adulthood. Outcomes in terms of life expectancy and renal function are favorable.
authors.affiliation: Department of Nephrology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan, kenzo@ii.e-mansion.com.
authors.forename: Kenji
authors.initials: K
authors.lastname: Ishikura
authors.forename: Norishige
authors.initials: N
authors.lastname: Yoshikawa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nakazato
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sasaki
authors.forename: Koichi
authors.initials: K
authors.lastname: Nakanishi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsuyama
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ito
authors.forename: Yuko
authors.initials: Y
authors.lastname: Hamasaki
authors.forename: Nahoko
authors.initials: N
authors.lastname: Yata
authors.forename: Takashi
authors.initials: T
authors.lastname: Ando
authors.forename: Kazumoto
authors.initials: K
authors.lastname: Iijima
authors.forename: Masataka
authors.initials: M
authors.lastname: Honda
mesh_terms: D002648:Child; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D009404:Nephrotic Syndrome / Q000150:complications* / Q000188:drug therapy*; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine