scholarly journals Cyclosporine A Effect on Hearing in Children with Steroid Dependent Nephrotic Syndrome and Steroid Resistant Nephrotic Syndrome.

GEGET ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 14-24
Author(s):  
Mohamed El Farsy ◽  
Maged Ashraf Abd El Fattah ◽  
Fathy Fatouh ◽  
Ahmed Abd El Fattah
Keyword(s):  
Nephrotic Syndrome ◽  
Cyclosporine A ◽  
Steroid Resistant ◽  
Steroid Resistant Nephrotic Syndrome ◽  
Steroid Dependent ◽  
Steroid Dependent Nephrotic Syndrome

scholarly journals Rituximab Use in Nephrotic Syndrome

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Nephrotic Syndrome ◽  
Mycophenolate Mofetil ◽  
Side Effects ◽  
Calcineurin Inhibitor ◽  
Minimal Change ◽  
Steroid Resistant ◽  
Steroid Resistant Nephrotic Syndrome ◽  
Steroid Dependent ◽  
Minimal Change Glomerulonephritis ◽  
Steroid Dependent Nephrotic Syndrome

Background: Nephrotic syndrome may be caused by primary (idiopathic) renal disease or by a variety of secondary causes. Patients present with marked edema, proteinuria, hypoalbuminemia, and often hyperlipidemia. Treatment of most patients should include fluid and sodium restriction, oral or intravenous diuretics, and angiotensin-converting enzyme inhibitors. Adults with nephrotic syndrome may benefit from corticosteroid treatment. The treatment of patients with the steroid-resistant nephrotic syndrome (SRNS) and steroid-dependent nephrotic syndrome (SDNS) is challenging. On the basis of suggestions that B lymphocytes are crucial in the pathogenesis of the nephrotic syndrome, rituximab (a monoclonal antibody against CD20 antigen) is used in treatment of these patients. Aim of study: To evaluate the role of rituximaband mycophenolic acid in treatment of patientswith steroid-resistant (SRNS) and steroid-dependent nephrotic syndrome (SDNS), whom not respond or relapse after calcineurin inhibitor (CNI) (tacrolimus or cyclosporine) had been used. Patients and methods: Case series study was done between 2012 - 2015 in AL-Sadder Teaching Hospital Nephrology Center and record 40 patients with different age groups, males and females with different histopathological types (Minimal Change Glomerulonephritis, Focal Segmental Glomerulosclerosis, Mesengeo Prolifrative Glomerulonephritis). These patients were taking prednisilone and\or calcineurin inhibitor (tacrolimus “prograf”) or (cyclosporine “sandimmune”), and they get either Steroid Dependent Nephrotic Syndrome or Steroid Resistant Nephrotic Syndrome with frequent admission more than four time per year. To these patients we start rituximab intravenous infusion monthly for at least six months with the use of steroid and mycophenolate mofetil during these six months. The patients followed up for 3-12 months after initiation of rituximab by different investigations and the patients were classified according to their response into complete, partial and no response. After one year stop rituximab treatment, follow the patients clinically and by investigations for (1-2) years to determine which patients get relapse. Results: Majority (80%) of patients with nephrotic syndrome who had good response to rituximab were younger age group < 15 years. Better response to rituximab associated with Minimal Change Glomerulonephritis. There was significant reduction in blood urea, serum creatinine, urine (protein/creatinine) ratio and serum cholesterol. Serum albumin was significant elevated. Response to rituximab was not significantly associated with gender or steroid response. Majority of patients with good response not relapse and need more time for follow up. Relapsing after stopping rituximab not significantly associated with age, gender, histopathological type and steroid response. Conclusion: Rituximab and mycophenolate mofetil used in steroid-resistant nephrotic syndrome to get ride from side effects of calcineurine inhibitor (tacrolimus or cyclosporine). Rituximab and mycophenolate mofetil used in steroid-dependent nephrotic syndrome after calcineurine inhibitorto get ride from side effects of steroid. Improvement in renal function is result from stopping of calcineurine inhibitor (nephrotoxic drugs) and/or from rituximab and mycophenolate mofetil. Cost of rituximab is less than the cost that needed if the patients had frequent admissions to the hospital or developed renal failure and ended with dialysis.

Long-Term Cyclosporine A Treatment of Steroid-Resistant and Steroid-Dependent Nephrotic Syndrome

1991 ◽  
Vol 18 (5) ◽  
pp. 583-588 ◽  
Author(s):  
Teresita L. Melocoton ◽  
Elaine S. Kamil ◽  
Arthur H. Cohen ◽  
Richard N. Fine
Keyword(s):  
Nephrotic Syndrome ◽  
Cyclosporine A ◽  
Steroid Resistant ◽  
Steroid Dependent ◽  
Steroid Dependent Nephrotic Syndrome

scholarly journals The effectiveness of cyclosporine A for patients with steroid-resistant nephrotic syndrome

Medicine ◽  
2021 ◽  
Vol 100 (49) ◽  
pp. e28186
Author(s):  
Juan Lv ◽  
Shizhi Luo ◽  
Yunxia Zhang ◽  
Enlai Dai
Keyword(s):  
Nephrotic Syndrome ◽  
Cyclosporine A ◽  
Steroid Resistant ◽  
Steroid Resistant Nephrotic Syndrome

Clinical evaluation of chronic nephrotoxicity of long-term cyclosporine A treatment in adult patients with steroid-dependent nephrotic syndrome

Nephrology ◽  
2011 ◽  
Vol 16 (3) ◽  
pp. 319-325 ◽  
Author(s):  
TOMONARI OKADA ◽  
HIROSHI MATSUMOTO ◽  
YUME NAGAOKA ◽  
RYO TOMARU ◽  
HIDEAKI IWASAWA ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Clinical Evaluation ◽  
Cyclosporine A ◽  
Adult Patients ◽  
Steroid Dependent ◽  
Steroid Dependent Nephrotic Syndrome

Fifteen-year remission of a steroid-resistant nephrotic syndrome sustained by cyclosporine A

2007 ◽  
Vol 22 (4) ◽  
pp. 600-602 ◽  
Author(s):  
Jens Drube ◽  
Christoph Geerlings ◽  
Ruth Taylor ◽  
Michael Mengel ◽  
Jochen H. H. Ehrich
Keyword(s):  
Nephrotic Syndrome ◽  
Cyclosporine A ◽  
Steroid Resistant ◽  
Steroid Resistant Nephrotic Syndrome

Tacrolimus in steroid-resistant and steroid-dependent nephrotic syndrome

2006 ◽  
Vol 65 (06) ◽  
pp. 393-396 ◽  
Author(s):  
T.H. Westhoff ◽  
S. Schmidt ◽  
W. Zidek ◽  
J. Beige ◽  
M. van der Giet
Keyword(s):  
Nephrotic Syndrome ◽  
Steroid Resistant ◽  
Steroid Dependent ◽  
Steroid Dependent Nephrotic Syndrome

scholarly journals Relative safety of steroid sparing agents in frequently relapsing, steroid dependent and steroid resistant nephrotic syndrome in pediatric patients

2020 ◽  
Vol 7 (8) ◽  
pp. 1762
Author(s):  
Sabnam Ara Begum ◽  
Santanu Kumar Tripathi ◽  
Mousumi Nandy ◽  
Sanat Kumar Ghosh ◽  
Shatavisa Mukherjee ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Adverse Events ◽  
Tertiary Care ◽  
Serious Adverse Events ◽  
Steroid Resistant ◽  
Steroid Resistant Nephrotic Syndrome ◽  
Steroid Dependent ◽  
Relative Safety ◽  
Tertiary Care Hospitals ◽  
Steroid Sparing

Background: In patients with frequently relapsing nephrotic syndrome (FRNS), steroid-dependent nephrotic syndrome (SDNS) and steroid resistant nephrotic syndrome (SRNS) steroids are either used for prolonged period of time or ineffective. To reduce the degree of steroid dependency and avoid steroid toxicity, several immunosuppressive steroid sparing agents (SPAs) have been proposed to treat these children. The present study tried to study the relative safety of most commonly steroid sparing agent in such children.Methods: A multi-centred, prospective observational study was conducted in paediatric nephrology OPD of two tertiary care hospitals in Kolkata over a period of 24 months. All consecutive children with diagnosed FRNS, SDNS and SRNS who were started on steroid sparing agents were enrolled and followed up for at least 6 months. Records of clinical examination, laboratory tests were collected and measured at the baseline and regular intervals. Safety parameters were noted and statistically analysed.Results: A total 110 patients were screened, examined and enrolled. Levamisole, cyclophosphamide and MMF were commonly used SPAs. Of the two tertiary care hospitals, all the patients of FRNS and SDNS were started with levamisole and SRNS with cyclophosphamide in one set-up, while in the other hospital some SDNS patients were started with cyclophosphamide and SRNS with MMF but without clinically significant outcomes. In comparison with few minor adverse events in MMF group, some serious adverse events were documented in the both cyclophosphamide and levamisole groups.Conclusions: Levamisole being a very efficacious, safe and easily affordable drug, should be used as an initial first line SPA in treating FRNS and SDNS children. The side effect profiles of levamisole and MMF are much more patient friendly.

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