Skip to main content
Log in

Cyclosporin in the treatment of idiopathic nephrotic syndrome in children

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Thirty-five children (12 girls, 23 boys), aged from 1 year and 5 months to 14 years at the onset of idiopathic nephrotic syndrome, received cyclosporin A (CyA) because of steroid toxicity or failure to respond to steroids. The initial oral dose was 6 mg/kg per day and this was adjusted to obtain trough plasma levels of 50–150 ng/ml. The duration of treatment was between 2 and 8 months. In patients who responded to CyA treatment, the dosage was tapered off; treatment was stopped if found to be ineffective. Of the 35 children, 20 were frequent-relapsing steroid responders who suffered serious side-effects from steroid therapy. Seventeen of them either went into remission or did not relapse despite the withdrawal of prednisone. Prednisone doses could be lowered but not stopped in 1 patient and the remaining 2 patients relapsed when prednisone was tapered off. At the final examination, 10 of the 12 children in whom CyA was tapered off and who had initially responded to CyA had relapsed. A second course was given to these 10 patients and 3 failed to respond. Five children were partial steroid responders and CyA induced a remission in 1 and a partial remission in another. Among the 10 children who were steroid resistant, only 1 responded to CyA, 2 had a partial response and 7 failed to respond to CyA. A reduction of glomerular filtration rate occurred in 8 patients, 7 of whom had either persistent nephrotic syndrome or were in relapse, which suggests that factors other than CyA nephrotoxicity may have been operative. Complete reversal occurred in only 4 patients. Significant histological changes, likely to be related to CyA, were seen in 2 repeat renal biopsies out of the 11 performed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Tejani A, Butt K, Khawar R, Suthabthuran M, Rosenthal CJ, Tachtman H, Fusi M (1985) Cyclosporine (Cy) induced remission of relapsing nephrotic syndrome (RNS) in children. Kidney Int 29: 206

    Google Scholar 

  2. Meyrier A, Simon P, Perret GF, Condamin-Meyrier MC (1986) Remission of idiopathic nephrotic syndrome after treatment with Cyclosporine A. Br Med J 292: 789–792

    Google Scholar 

  3. Hoyer PF, Krull F, Brodehl J (1986) Cyclosporin in frequently relapsing minimal change nephrotic syndrome. Lancet II: 335

    Google Scholar 

  4. Capodicasa G, De Santo NG, Nuzzi F, Giordano C (1986) Cyclosporine A in nephrotic syndrome of childhood. A 14 month experience. Int J Pediatr Nephrol 7: 69–72

    PubMed  Google Scholar 

  5. Brandis M, Burghard R, Leititis J, Zimerhackl B, Hildbrandt F, Helmchen U (1987) Cyclosporin A for treatment in nephrotic syndrome. Pediatr Nephrol 1: C42

    Google Scholar 

  6. Lokiec F, Devergie A, Poirier O, Gluckman E (1983) Pharmacologic monitoring in the clinical use of Cyclosporine. Transplant Proc 15: S 226–229

    Google Scholar 

  7. Habib R, Churg J (1984) Minimal change disease, measangial proliferation glomerulonephritis and focal sclerosis: individual entities or a spectrum of disease. In: Robinson RR (ed) Nephrology. Springer, Berlin Heidelberg New York, pp 634–644

    Google Scholar 

  8. Palestine AG, Austin HA, Balow JE, Antonovycht T, Sabnis SG, Preuss HG, Nussenblatt RB (1986) Renal histopathologic alterations in patients treated with Cyclosporine for uveitis. N Engl J Med 314:1293–1298

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Niaudet, P., Habib, R., Tete, MJ. et al. Cyclosporin in the treatment of idiopathic nephrotic syndrome in children. Pediatr Nephrol 1, 566–573 (1987). https://doi.org/10.1007/BF00853590

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00853590

Key words

Navigation