title: Montelukast as an add-on treatment in steroid dependant nephrotic syndrome, randomised-controlled trial.
abstract: BACKGROUND
  The underlying mechanisms of nephrotic syndrome (NS) are still under debate and the need for more effective and less toxic treatment is challenging. We aimed to evaluate the efficacy of montelukast, a leukotriene receptor antagonist as an add-on therapy, and to explore the leukotriene (LT) biology in steroid-dependent nephrotic syndrome (SDNS).
  
  
  METHODS
  A randomized controlled trial was conducted including 32 patients with SDNS who were randomly assigned to receive standard steroid treatment only [low-dose steroid (LDS) group] or standard steroid therapy plus montelukast (Montelukast group). Urine protein/creatinine ratio, serum albumin, creatinine, cholesterol, and plasma LTs (LTB4/C4/D4/E4) were evaluated in all patients before and after treatment.
  
  
  RESULTS
  After treatment, both groups showed a significant decrease of LTB4 and LTC4/D4/E4. Further, the Montelukast group showed a significant decrease in serum creatinine and a significant increase in diastolic blood pressure and protein/creatinine ratio. It also showed a marked decrease in plasma LTC4/D4/E4 compared to the LDS group, although not statistically significant.
  
  
  CONCLUSIONS
  Our findings highlight the effect of montelukast on renal function, but suggest that the clinical and laboratory efficacy of the addition of montelukast to steroids in maintenance treatment of SDNS is debatable.
authors.affiliation: Faculty of Medicine, Allergy, Respiratory and Clinical Immunology Unit, Pediatric Department, Mansoura University, Mansoura, Egypt. magdyzedan@yahoo.com.
authors.forename: Magdy Mohamed
authors.initials: MM
authors.lastname: Zedan
authors.affiliation: Faculty of Medicine, Nephrology Unit, Pediatric Department, Mansoura University, Mansoura, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: El-Refaey
authors.affiliation: Faculty of Medicine, Clinical Pathology Department, Mansoura University, Mansoura, Egypt.
authors.forename: Hosam
authors.initials: H
authors.lastname: Zaghloul
authors.affiliation: Faculty of Pharmacy, Clinical Pharmacy Department, BeniSuef University, Benisuef, Egypt.
authors.forename: Mohamed E A
authors.initials: ME
authors.lastname: Abdelrahim
authors.affiliation: Faculty of Medicine, Allergy, Respiratory and Clinical Immunology Unit, Pediatric Department, Mansoura University, Mansoura, Egypt.
authors.forename: Amal
authors.initials: A
authors.lastname: Osman
authors.affiliation: Faculty of Medicine, Nephrology Unit, Pediatric Department, Mansoura University, Mansoura, Egypt.
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: Zedan
authors.affiliation: Faculty of Pharmacy, Clinical Pharmacy Department, BeniSuef University, Benisuef, Egypt.
authors.forename: Nashwa
authors.initials: N
authors.lastname: Eltantawy
mesh_terms: D000085:Acetates / Q000008:administration & dosage*; D000293:Adolescent; D002648:Child; D003521:Cyclopropanes; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007677:Kidney Function Tests; D020024:Leukotriene Antagonists / Q000008:administration & dosage*; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D011804:Quinolines / Q000008:administration & dosage*; D013440:Sulfides; D016896:Treatment Outcome
chemical_list: D000085:Acetates; D003521:Cyclopropanes; D005938:Glucocorticoids; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; C093875:montelukast
keywords: Leukotrienes; Montelukast; Steroid-dependent nephrotic syndrome