Medium-Term Outcome of Cyclosporine in Children with Steroid-Dependent Nephrotic Syndrome: Single Centre experience from Pakistan
Objective: To determine the medium-term outcome of Cyclosporine in children with steroid-dependent nephrotic syndrome from a single centre in Pakistan Study Design: Prospective longitudinal study Place and Duration of Study: Pediatric Nephrology Department of Sindh Institute of Urology and Tran...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Army Medical College Rawalpindi
2023-10-01
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| Series: | Pakistan Armed Forces Medical Journal |
| Subjects: | |
| Online Access: | https://www.pafmj.org/PAFMJ/article/view/7197 |
| _version_ | 1797341026027831296 |
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| author | Saima Kashif Madiha Aziz Pawan Kumar Sana Ullah Agha Ali Asghar Lanewala Seema Hashmi |
| author_facet | Saima Kashif Madiha Aziz Pawan Kumar Sana Ullah Agha Ali Asghar Lanewala Seema Hashmi |
| author_sort | Saima Kashif |
| collection | DOAJ |
| description |
Objective: To determine the medium-term outcome of Cyclosporine in children with steroid-dependent nephrotic syndrome from a single centre in Pakistan
Study Design: Prospective longitudinal study
Place and Duration of Study: Pediatric Nephrology Department of Sindh Institute of Urology and Transplantation, Karachi
Pakistan from Jan 2014 to Dec 2016.
Methodology: All consecutive patients with steroid-dependent nephrotic syndrome of either gender, between 1-12 years of age, were identified and included in this study, who relapsed post-Cyclophosphamide therapy and were prescribed
Cyclosporine after renal biopsy.
Results: Seventy-five children with steroid-dependent nephrotic syndrome met the inclusion criteria. There were 55(74%) boys with a mean age of 4.3 ± 2.5 years, while the mean age at the start of Cyclosporine therapy was 6.5 ± 1.5 years. All patients were previously treated with Cyclophosphamide, and sustained remission was achieved for 37.6 ± 43.6 weeks. All patients underwent renal biopsy showing minimal change disease in 46(61.3%) subjects, focal segmental glomerulosclerosis in 12(16%), IgM nephropathy in 13(17.3%) and mesangioproliferative glomerulonephritis in 4(5.3%) children. At the last follow-up, 36(48%) patients were in complete remission, 26(35%) achieved partial remission, seven children (9.3%) did not achieve remission at all, 2(2.7%) were lost to follow-up, and 4(5.3%) patients expired. The mean estimated glomerular filtration rate at the start of Cyclosporine was 112.55 ml/min/1.73 m2, which declined to 107.77 ml/min/1.73 m2 at three years.
Conclusion: In the medium term, Cyclosporine effectively maintains remission and reduces steroid usage with minimal
nephrotoxicity in steroid-dependent nephrotic syndrome.
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| first_indexed | 2024-03-08T10:11:56Z |
| format | Article |
| id | doaj.art-9e5b1911ba6f407892284f6d0ddf38a0 |
| institution | Directory Open Access Journal |
| issn | 0030-9648 2411-8842 |
| language | English |
| last_indexed | 2024-03-08T10:11:56Z |
| publishDate | 2023-10-01 |
| publisher | Army Medical College Rawalpindi |
| record_format | Article |
| series | Pakistan Armed Forces Medical Journal |
| spelling | doaj.art-9e5b1911ba6f407892284f6d0ddf38a02024-01-29T08:27:21ZengArmy Medical College RawalpindiPakistan Armed Forces Medical Journal0030-96482411-88422023-10-0173510.51253/pafmj.v73i5.7197Medium-Term Outcome of Cyclosporine in Children with Steroid-Dependent Nephrotic Syndrome: Single Centre experience from PakistanSaima Kashif0Madiha Aziz1Pawan Kumar2Sana Ullah Agha3Ali Asghar Lanewala4Seema Hashmi5Department of Urology, Sindh Institute Urology and Transplantation, Sindh PakistanDepartment of Urology, Sindh Institute Urology and Transplantation, Sindh PakistanDepartment of Urology, Sindh Institute Urology and Transplantation, Sindh PakistanDepartment of Urology, Sindh Institute Urology and Transplantation, Sindh PakistanDepartment of Urology, Sindh Institute Urology and Transplantation, Sindh PakistanDepartment of Urology, Sindh Institute Urology and Transplantation, Sindh Pakistan Objective: To determine the medium-term outcome of Cyclosporine in children with steroid-dependent nephrotic syndrome from a single centre in Pakistan Study Design: Prospective longitudinal study Place and Duration of Study: Pediatric Nephrology Department of Sindh Institute of Urology and Transplantation, Karachi Pakistan from Jan 2014 to Dec 2016. Methodology: All consecutive patients with steroid-dependent nephrotic syndrome of either gender, between 1-12 years of age, were identified and included in this study, who relapsed post-Cyclophosphamide therapy and were prescribed Cyclosporine after renal biopsy. Results: Seventy-five children with steroid-dependent nephrotic syndrome met the inclusion criteria. There were 55(74%) boys with a mean age of 4.3 ± 2.5 years, while the mean age at the start of Cyclosporine therapy was 6.5 ± 1.5 years. All patients were previously treated with Cyclophosphamide, and sustained remission was achieved for 37.6 ± 43.6 weeks. All patients underwent renal biopsy showing minimal change disease in 46(61.3%) subjects, focal segmental glomerulosclerosis in 12(16%), IgM nephropathy in 13(17.3%) and mesangioproliferative glomerulonephritis in 4(5.3%) children. At the last follow-up, 36(48%) patients were in complete remission, 26(35%) achieved partial remission, seven children (9.3%) did not achieve remission at all, 2(2.7%) were lost to follow-up, and 4(5.3%) patients expired. The mean estimated glomerular filtration rate at the start of Cyclosporine was 112.55 ml/min/1.73 m2, which declined to 107.77 ml/min/1.73 m2 at three years. Conclusion: In the medium term, Cyclosporine effectively maintains remission and reduces steroid usage with minimal nephrotoxicity in steroid-dependent nephrotic syndrome. https://www.pafmj.org/PAFMJ/article/view/7197Children CyclosporineNephrotic syndromeSteroid-dependent |
| spellingShingle | Saima Kashif Madiha Aziz Pawan Kumar Sana Ullah Agha Ali Asghar Lanewala Seema Hashmi Medium-Term Outcome of Cyclosporine in Children with Steroid-Dependent Nephrotic Syndrome: Single Centre experience from Pakistan Pakistan Armed Forces Medical Journal Children Cyclosporine Nephrotic syndrome Steroid-dependent |
| title | Medium-Term Outcome of Cyclosporine in Children with Steroid-Dependent Nephrotic Syndrome: Single Centre experience from Pakistan |
| title_full | Medium-Term Outcome of Cyclosporine in Children with Steroid-Dependent Nephrotic Syndrome: Single Centre experience from Pakistan |
| title_fullStr | Medium-Term Outcome of Cyclosporine in Children with Steroid-Dependent Nephrotic Syndrome: Single Centre experience from Pakistan |
| title_full_unstemmed | Medium-Term Outcome of Cyclosporine in Children with Steroid-Dependent Nephrotic Syndrome: Single Centre experience from Pakistan |
| title_short | Medium-Term Outcome of Cyclosporine in Children with Steroid-Dependent Nephrotic Syndrome: Single Centre experience from Pakistan |
| title_sort | medium term outcome of cyclosporine in children with steroid dependent nephrotic syndrome single centre experience from pakistan |
| topic | Children Cyclosporine Nephrotic syndrome Steroid-dependent |
| url | https://www.pafmj.org/PAFMJ/article/view/7197 |
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