DOI: https://doi.org/10.14710/dmj.v13i2.41983

Clinical Profile of Pediatric Patients with Steroid-resistant Nephrotic Syndrome Treated by Cyclophosphamide, Cyclosporin A, Mycophenolate Mofetile and Tacrolimus in Hasan Sadikin General Hospital

*Ahmedz Widiasta orcid scopus publons  -  Nephrology Division, Child Health Department, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia, Indonesia
Muhammad Khalid Jambak  -  Nephrology Division, Child Health Department, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia, Indonesia
Nanan Sekarwana  -  Nephrology Division, Child Health Department, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia, Indonesia

Citation Format:
Abstract

Background: Steroid-resistant nephrotic syndrome is a major cause of chronic kidney disease in children and adolescents. These diseases require appropriate management, while in some developing countries; the availability of agents recommended by international guidelines is very limited. Research objectives: To determine and describe the patient profiles of pediatric Steroid Resistant Nephrotic Syndrome (SRNS) that use Cyclophosphamide (CPA), Cyclosporine(CyA), Tacrolimus, and Mycofenolat Mofetil (MMF) in Dr. Hasan Sadikin Hospital (RSHS), Bandung as a tertiary hospital in West Java, Indonesia. Methods and materials: This research used a retrospective study with crosssectional study design, total sampling method and medical record of pediatric (1-18 years old) patients from January 1st 2017–September 31st 2019 who were diagnosed as SRNS. Results : From 99 subjects that belonged to inclusion criteria, 35.4% pediatric SRNS patients were in the age group 6-10 years and 60.6% were males. Laboratorium profiles showed among all population, ureum <100 mg/dL were found as high as 97%, creatinine 0.3-1.0 mg/dL (71.7%) albumin >2,5 gr/dL (51.5%), negative hematuria (68.7%) , protein dipstick < 3 (50.5%), and LFG > 90 mL/min/1.73 m2 (79.8%).. The patients generally had use CPA (87.9%) and remission <6 month (51.5%). Conclusion: Profiles of pediatric patients are important to diagnose and prognose SRNS. By using these approaches, it is feasible to access and detect the most effective treatment for SRNS.

Note: This article has supplementary file(s).

Fulltext View|Download |  Research Instrument
Untitled
Subject
Type Research Instrument
  Download (16KB)    Indexing metadata
 Research Instrument
Untitled
Subject
Type Research Instrument
  Download (29KB)    Indexing metadata
Keywords: Steroid-resistant nephrotic syndrome, laboratorium profile, remission, cyclophosphamide, cyclosporine, mycofenolate mofetil, tacrolimus, pediatric.
Funding: -

Article Metrics:

Article Info
Section: Original Articles
Language : EN
Recent articles
Factors Associated with The Choice of Place of Delivery in Coastal Communities in The Working Area of Bonegunu Community Health Center North Buton District Effects of Garcinia Mangostana Linn Pericarp Extract and Physical Exercise on Atheroembolic Histopathologic Features Kidney in Wistar Rats with Metabolic Syndrome Clinical Profile of Pediatric Patients with Steroid-resistant Nephrotic Syndrome Treated by Cyclophosphamide, Cyclosporin A, Mycophenolate Mofetile and Tacrolimus in Hasan Sadikin General Hospital Case Report: Successful Management of Ischemic Stroke Patients with Pneumonia, Diabetes Mellitus, and Hypertension in The ICU Case Report: Diagnosis and Management of Body Stalk Anomaly More recent articles
  1. Eddy AA, Symons JM. Nephrotic syndrome in childhood. Lancet. 2003;362(9384):629–39
  2. Clark AG. Steroid-responsive nephrotic syndrome. Pediatr Nephrol. 1999;
  3. Lombel RM, Gipson DS, Hodson EM. Treatment of steroid-sensitive nephrotic syndrome: New guidelines from KDIGO. Pediatr Nephrol. 2013;28(3):415–26
  4. MacHardy N, Miles P V., Massengill SF, Smoyer WE, Mahan JD, Greenbaum L, et al. Management patterns of childhood-onset nephrotic syndrome. Pediatr Nephrol. 2009;24(11):2193–201
  5. Abrantes MM, Cardoso LSB, Lima EM, Silva JMP, Diniz JS, Bambirra EA, et al. Predictive factors of chronic kidney disease in primary focal segmental glomerulosclerosis. Pediatr Nephrol. 2006;21(7):1003–12
  6. Colquitt JL, Kirby J, Green C, Cooper K, Trompeter RS. The clinical effectiveness and cost-effectiveness of treatments for children with idiopathic steroid-resistant nephrotic syndrome: A systematic review. Health Technol Assess (Rockv). 2007;11(21)
  7. Lombel RM, Hodson EM, Gipson DS. Treatment of steroid-resistant nephrotic syndrome in children: New guidelines from KDIGO. Pediatr Nephrol. 2013;28(3):409–14
  8. Silverstein DM, Matti Vehaskari V, Symons JM, Alon US, Straatmann C. Steroid-Resistant Nephrotic Syndrome. Pediatr Nephrol. 2012;369–402
  9. Alatas H, Trihono PP. Pengobatan Terkini Sindrom Nefrotik (SN) pada Anak. Sari Pediatr. 2016;17(2):155
  10. Barletta G-M, Smoyer WE, Bunchman TE, Flynn JT, Kershaw DB. Use of mycophenolate mofetil in steroid-dependent and-resistant nephrotic syndrome. Pediatr Nephrol. 2003;18(8):833–7
  11. Li Z, Duan C, He J, Wu T, Xun M, Zhang Y, et al. Mycophenolate mofetil therapy for children with steroid-resistant nephrotic syndrome. Pediatr Nephrol. 2010;25(5):883–8
  12. Hidayati EL, Pardede SO, Trihono PP. Comparison of oral and intravenous cyclophosphamide in children with steroid-resistant nephrotic syndrome. Paediatr Indones. 2011;51(5):266–71
  13. Subandiyah K. The outcome of nephrotic syndrome in children-prospective population based cohort study. J Kedokt Brawijaya. 2004;20(3):147–51
  14. Wati KDK, Suarta K, Soetjiningsih S. Tinggi Badan dan Usia Tulang Sindrom Nefrotik yang Mendapat Terapi Steroid Jangka Panjang. Sari Pediatr. 2016;4(2):83
  15. Prasad N, Gulati S, Sharma RK, Singh U, Ahmed M. Pulse cyclophosphamide therapy in steroid-dependent nephrotic syndrome. Pediatr Nephrol. 2004;19(5):494–8
  16. Haycock G. The child with idiopathic nephrotic syndrome. Clin Paediatr Nephrolgy. 2003;341–66
  17. Wang C shi, Greenbaum LA. Nephrotic Syndrome. Pediatr Clin North Am [Internet]. 2019;66(1):73–85. Available from: https://doi.org/10.1016/j.pcl.2018.08.006
  18. Obeidová H, Merta M, Reiterová J, Maixnerová D, Stekrová J, Rysavá R, et al. Genetic basis of nephrotic syndrome—review. Prague Med Rep. 2006;107(1):5–16
  19. Woodroffe R al, Yao GL, Meads C, Bayliss S, Ready A, Raftery J, et al. Clinical and cost-effectiveness of newer immunosuppressive regimens in renal transplantation: a systematic review and modelling study. In: NIHR Health Technology Assessment programme: Executive Summaries. NIHR Journals Library; 2005
  20. Otukesh H, Otukesh S, Mojtahedzadeh M, Hoseini R, Fereshtehnejad S, Fard AR, et al. IJKD H Otukesh management and outcome of SRNS in children.pdf. 2009;3(4):210–7
  21. Antignac C. Genetic models: clues for understanding the pathogenesis of idiopathic nephrotic syndrome. J Clin Invest. 2002;109(4):447–9
  22. Alatas H, Tambunan T, Trihono PP, Pardede SO. Konsensus tata laksana sindrom nefrotik idiopatik pada anak. Jakarta UKK Nefrol IDAI. 2005;1–17
  23. Garin EH, Orak JK, Hiott KL, Sutherland SE. Cyclosporine therapy for steroid-resistant nephrotic syndrome: a controlled study. Am J Dis Child. 1988;142(9):985–8

Last update:

No citation recorded.

Last update:

No citation recorded.