title: Use of Cyclosporine Therapy in Steroid Resistant Nephrotic Syndrome (SRNS): A Review.
abstract: A chronic, progressive disorder Steroid Resistant Nephrotic Syndrome (SRNS) accounts for 10-20% of all children with Nephrotic Syndrome. It is a heterogeneous disorder comprised of persistent edema, proteinuria, hypoalbuminemia and hyperlipidemia. Treatment for steroid-resistant nephrotic syndrome (SRNS) is challenging and children who suffer from SRNS require aggressive treatment to achieve remission. Calcineurin inhibitors have been used more in an empirical manner than on the basis of clear rationale. It was in 1984 when cyclosporine was first considered for the treatment of steroid resistant nephrotic syndrome. Cyclosporin is a calcineurin inhibitor that suppresses immune response by downregulating the transcription of various cytokine genes. Till now many studies have been conducted to determine dosages, duration of therapy, side effects and advantages of cyclosporine. Treatment of SRNS remains a difﬁcult challenge in pediatric nephrology.  Treatment should be individualized according to the underlying histopathology, and clinical and environmental conditions of the children. There is an urgent need to distinguish as soon as possible those patients who may beneﬁt from prolonged immunosuppressive treatment from those who will not beneﬁt from such treatment and who will just suffer from its major side effects. The emerging evidence that the majority of genetic forms of SRNS should receive symptomatic treatment only, should also be clinically tested and studies baring its significance should be evaluated in the future.
authors.affiliation: Dow Medical College, Dow University of Health Sciences (DUHS). syedraza91shah@live.com.
authors.forename: Syed Raza
authors.initials: SR
authors.lastname: Shah
authors.forename: Areeba
authors.initials: A
authors.lastname: Altaf
authors.forename: Mohammad Hussham
authors.initials: MH
authors.lastname: Arshad
authors.forename: Anum
authors.initials: A
authors.lastname: Mari
authors.forename: Sahir
authors.initials: S
authors.lastname: Noorani
authors.forename: Eraj
authors.initials: E
authors.lastname: Saeed
authors.forename: Areesh Amir
authors.initials: AA
authors.lastname: Mevawalla
authors.forename: Zaiyn Ul
authors.initials: ZU
authors.lastname: Haq
authors.forename: Muhammad Ehsan
authors.initials: ME
authors.lastname: Faquih
mesh_terms: D002648:Child; D016572:Cyclosporine / Q000627:therapeutic use*; D004351:Drug Resistance; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D013256:Steroids / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids; D016572:Cyclosporine