期刊论文详细信息
Jornal Brasileiro de Nefrologia
Immunosupressive therapy in children with steroid-resistant nephrotic syndrome: single center experience
Catalina Velez Echeverri2  Gustavo Adolfo Zuluaga Valencia1  Lina Maria Serna Higuita2  Ana Katherina Serrano Gayubo1  Carolina Lucia Ochoa1  Luisa Fernanda Rojas Rosas1  Laura Carolina Muñoz1  Javier Sierra1  Jhon Jairo Zuleta1  Juan José Vanegas Ruiz2 
[1],Antioquia University Hospital Pablo Tobon Uribe
关键词: immunosuppressive agents;    kidney failure;    chronic;    mycophenolic acid;    nephrotic syndrome;    agentes imunossupressores;    insuficiência renal;    crônica;    síndrome nefrótica;    ácido micofenólico;   
DOI  :  10.5935/0101-2800.20130032
来源: SciELO
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【 摘 要 】
INTODUCTION: Nephrotic syndrome is one of the most frequent glomerular diseases among children, and steroid therapy remains as the treatment choice. In spite of this, 10 to 15% of the patients are steroidresistant, and the best therapy for such cases has never been defined. Mycophenolate acid (MA) is one of the treatments used in such situations. OBJECTIVE: To describe the clinical behavior of children diagnosed with steroid-resistant nephrotic syndrome (SRNS) and to assess the therapeutic response to MA. METHODS: This was a retrospective and descriptive study. RESULTS: 26 clinical records of patients with SRNS; 70% male and 30% female. All patients underwent kidney biopsies, which showed a predominance of focal segmental glomerulosclerosis (FSGS). The immunosuppresive drugs used were: Mycophenolate mofetil (MMF) 100%, Cyclosporine 69.2%, Cyclophosphamide 23.1%, and Rituximab 23%. One month after treatment initiation with MMF 61.5% achieved remission. The median of relapses per year for the patients was 3 (p25: 2.75 - p75: 4). This median became 1 (p25: 1 - p75: 3.25) after using this medication (p = 0.08). Furthermore, prior to the start of the MMF treatment, the median of the steroid dose was 1 (p25: 0.5- p75: 1.62) mg/k/day. After using MMF, this median became 0.07 (p25: 0 - p75: 0.55) mg/k/day (p < 0.001), in 8 patients prednisolone was stopped. CONCLUSION: In our experience, treatment with MMF showed positive results such as decrease in the frequency of relapses, less proteinuria, and reduction in the dose of steroids administered without deterioration of glomerular filtration rates. However, more studies are needed to assess efficacy, safety, and optimal dosage.
【 授权许可】

CC BY   
 All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License

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