ArticleEuropean journal of pediatrics1992
Long-term low-dose cyclosporin A in steroid dependent nephrotic syndrome of childhood.
Article in European journal of pediatrics, 1992. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Clinical practice guideline for pediatric idiopathic nephrotic syndrome 2013: medical therapy.Clinical and experimental nephrology · 2015Guideline
- Steroid-resistant, cyclosporine-responsive, relapsing nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 1995Trial
- Cyclosporine-A-induced nephrotoxicity in children with minimal-change nephrotic syndrome: long-term treatment up to 10 years.Pediatric nephrology (Berlin, Germany) · 2008Article
- Impact of the cyclosporine-ketoconazole interaction in children with steroid-dependent idiopathic nephrotic syndrome.European journal of clinical pharmacology · 2006Article
- Cyclosporine therapy monitored with abbreviated area under curve in nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2005Article
- Cyclosporin A does not affect platelets in children with idiopathic nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2005Article
- Cyclosporin A therapy in refractory non-infectious childhood uveitis.The British journal of ophthalmology · 1998Article
- Effect of cyclosporin A on glomerular filtration rate in children with minimal change nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 1994Article
- Long-term cyclosporin A treatment of minimal-change nephrotic syndrome of childhood.Pediatric nephrology (Berlin, Germany) · 1994Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Therapy of steroid-dependent idiopathic nephrotic syndrome is often unsatisfactory. Since 1986 we have treated nine children (six male and three female), aged 3-16 years, with cyclosporin A (CsA) during 2.0-5.2 (median 3.1) years. All had minimal change disease on renal biopsy and had previously received cyclophosphamide. Mean daily dosage of CsA was 4.1 mg/kg (range 2.7-5.8) and mean whole blood trough level was 220 ng/ml (range 141-271). The relapse rate decreased from 3.4/patient year before CsA to 0.55 on CsA. Discontinuation of CsA or reduction below 2 mg/kg daily was always followed by a relapse. The overall relapse rate, including the period with very low-dose CsA, was 0.95/patient year. Four patients required additional low-dose alternate-day prednisone. Repeat renal biopsy showed minimal change disease in eight patients and focal segmental glomerulosclerosis in one; CsA-toxicity was mild in two and moderate in one. The latter was the only patient with slightly reduced glomerular filtration rate. Two boys with delayed puberty spontaneously matured and reached expected final height. We conclude that long-term low-dose CsA is very effective and steroid-sparing. Its use is justified in selected patients, particularly in those with numerous relapses and in male patients before and during puberty, as long as renal function and CsA-toxicity are carefully monitored.
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