Trial reportPediatric nephrology (Berlin, Germany)2003
Intravenous cyclophosphamide in steroid-resistant nephrotic syndrome.
Trial report in Pediatric nephrology (Berlin, Germany), 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- IPNA clinical practice recommendations for the diagnosis and management of children with steroid-resistant nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2020Guideline
- Prospective 5-year follow-up of cyclosporine treatment in children with steroid-resistant nephrosis.Pediatric nephrology (Berlin, Germany) · 2013Trial
- Efficacy of intravenous pulse cyclophosphamide treatment versus combination of intravenous dexamethasone and oral cyclophosphamide treatment in steroid-resistant nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2008Trial
- Cyclosporin A is superior to cyclophosphamide in children with steroid-resistant nephrotic syndrome-a randomized controlled multicentre trial by the Arbeitsgemeinschaft für Pädiatrische Nephrologie.Pediatric nephrology (Berlin, Germany) · 2008Trial
- Mycophenolate mofetil in steroid/cyclosporine-dependent/resistant nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2005Trial
- Intravenous pulse cyclophosphamide--is it effective in children with steroid-resistant nephrotic syndrome?Pediatric nephrology (Berlin, Germany) · 2003Trial
- Intravenous cyclophosphamide therapy in children with calcineurin inhibitor-resistant steroid-resistant nephrotic syndrome in a resource-limited setting.Pediatric nephrology (Berlin, Germany) · 2024Article
- Intravenous cyclophosphamide induces remission in children with difficult to treat steroid resistant nephrotic syndrome from minimal change disease.BMC nephrology · 2021Article
- Current understandings in treating children with steroid-resistant nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2021Review
- Thrombotic microangiopathy triggered by podocytopathy.Clinical nephrology. Case studies · 2021Article
- Exploring the Clinical and Genetic Spectrum of Steroid Resistant Nephrotic Syndrome: The PodoNet Registry.Frontiers in pediatrics · 2018Review
- Long-Term Outcome of Steroid-Resistant Nephrotic Syndrome in Children.Journal of the American Society of Nephrology : JASN · 2017Article
- Long-term outcome of idiopathic steroid-resistant nephrotic syndrome in children.Pediatric nephrology (Berlin, Germany) · 2016Article
- Immunosuppressive therapy in children with steroid-resistant, frequently-relapsing, and steroid-dependent idiopathic nephrotic syndrome: a single center experience.Electronic physician · 2016Article
- Calcineurin inhibitor induced nephrotoxicity in steroid resistant nephrotic syndrome.Indian journal of nephrology · 2013Article
- Article
- Long-term outcome of idiopathic steroid-resistant nephrotic syndrome: a multicenter study.Pediatric nephrology (Berlin, Germany) · 2009Article
- Experience with tacrolimus in children with steroid-resistant nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2009Article
- Therapies for steroid-resistant nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2008Article
- Clinical course and NPHS2 analysis in patients with late steroid-resistant nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2008Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We prospectively examined the effect of treatment with intravenous cyclophosphamide in patients with steroid-resistant nephrotic syndrome. Twenty-four patients (minimal change disease in 11, focal segmental glomerulosclerosis in 9, and mesangioproliferative glomerulonephritis in 4), who did not show remission of proteinuria despite treatment with 8 weeks of oral prednisolone and six intravenous pulses of dexamethasone, were studied. Cyclophosphamide was administered intravenously, at a dose of 750 mg/m(2) once a month for 6 months; therapy with alternate-day prednisolone was continued. The mean (SD) age at treatment was 7.8 (4.0) years; 18 patients had initial resistance and 6 had late resistance. At the end of 6 months treatment, 7 (29.2%) patients each had complete remission (absent proteinuria, normal serum albumin) and partial remission (1-2+ proteinuria, normal serum albumin). Ten (41.6%) patients showed no response to therapy. The mean time to complete or partial remission, after initiation of treatment with cyclophosphamide, was 2.4+/-1.7 months and 2.7+/-1.8 months, respectively. Most responders (85.8% complete and 57.2% partial responders) achieved remission by the third dose of pulse cyclophosphamide. More patients with late resistance (50%) compared with initial resistance (22.2%) achieved complete remission. Partial remission was transient and lasted for a mean duration of 6.4+/-3.5 months. Serious infections were observed during therapy in 5 patients. On long-term follow-up, 5 (20.8%) patients were in remission, while nephrotic-range proteinuria or end-stage renal disease was seen in 17 (70.8%). Findings from the present study suggest that therapy with intravenous cyclophosphamide has limited efficacy in inducing sustained remission in patients with initial corticosteroid resistance. Sustained remission is likely to occur in a significant proportion of patients with late resistance and those with absence of significant tubulointerstitial changes on renal histology.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.