ArticlePediatric nephrology (Berlin, Germany)2006
Steroid-resistant nephrotic syndrome: the influence of race on cyclophosphamide sensitivity.
Article in Pediatric nephrology (Berlin, Germany), 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 39 citations in OpenAlex.
- 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
- Follow-up Outcomes of 100 Children with Frequently Relapsing and Steroid Dependent Nephrotic Syndrome Treated with Oral Cyclophosphamide: A Retrospective Cohort Study.Indian pediatrics · 2026Article
- Intravenous cyclophosphamide therapy in children with calcineurin inhibitor-resistant steroid-resistant nephrotic syndrome in a resource-limited setting.Pediatric nephrology (Berlin, Germany) · 2024Article
- Evaluation of Visual Acuity, Macular Thickness, and Level of Proteinuria in Children with Nephrotic Syndrome.Korean journal of ophthalmology : KJO · 2023Article
- Multiple Venous and Pulmonary Artery Thrombosis as a Presenting Complaint of Nephrotic Syndrome-Case Report and Challenges in Management.Vascular health and risk management · 2022Article
- Intravenous cyclophosphamide induces remission in children with difficult to treat steroid resistant nephrotic syndrome from minimal change disease.BMC nephrology · 2021Article
- Trends in the epidemiology of childhood nephrotic syndrome in Africa: A systematic review.Global epidemiology · 2021Review
- Oral cyclophosphamide therapy in 100 children with steroid-sensitive nephrotic syndrome: experience from a developing country.Pediatric nephrology (Berlin, Germany) · 2021Observational
- Management of idiopathic childhood nephrotic syndrome in sub-Saharan Africa: Ibadan consensus statement.Kidney international · 2021Article
- Prevalence rates of histopathologic subtypes associated with steroid resistance in childhood nephrotic syndrome in Sub-Saharan Africa: a systematic review.International journal of nephrology and renovascular disease · 2019Article
- Article
- Ethnic Differences in Childhood Nephrotic Syndrome.Frontiers in pediatrics · 2016Review
- Spectrum of steroid-resistant and congenital nephrotic syndrome in children: the PodoNet registry cohort.Clinical journal of the American Society of Nephrology : CJASN · 2015Article
- The rationale and design of Insight into Nephrotic Syndrome: Investigating Genes, Health and Therapeutics (INSIGHT): a prospective cohort study of childhood nephrotic syndrome.BMC nephrology · 2013Article
- Cyclophosphamide and 4-hydroxycyclophosphamide pharmacokinetics in patients with glomerulonephritis secondary to lupus and small vessel vasculitis.British journal of clinical pharmacology · 2012Article
- New therapies in steroid-sensitive and steroid-resistant idiopathic nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2011Review
- Experience with tacrolimus in children with steroid-resistant nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2009Article
- The spectrum of chronic kidney disease (stages 2-5) in KwaZulu-Natal, South Africa.Pediatric nephrology (Berlin, Germany) · 2008Article
- Corticosteroid-resistant nephrotic syndrome with focal and segmental glomerulosclerosis : an update of treatment options for children.Paediatric drugs · 2008Review
- Malaria-induced renal damage: facts and myths.Pediatric nephrology (Berlin, Germany) · 2007Review
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Authors and funding
3 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
Steroid-resistant (SR) forms of nephrotic syndrome (NS) have a poorer outcome in blacks compared to other racial groups. In this study, 223 children with SRNS, aged 1-16 years old, were analysed retrospectively for the period 1976-2004. Treatment schedules included oral cyclophosphamide (2-3 mg/kg) with prednisone 0.5-1 mg/kg (maximum 60 mg) only (n=90); prednisone on alternate days with methylprednisolone (30 mg/kg, maximum 1 g) and oral cyclophosphamide (n=117); oral prednisone on alternate days, three doses of intravenous methylprednisolone on alternate days and monthly doses of intravenous cyclophosphamide (500-750 mg m(-2) dose(-1)x7 doses monthly) (n=10); or cyclosporine 5 mg kg(-1) day(-1) adjusted to a trough level of 150-200 mg/ml (n=6). We compared the clinical and biochemical characteristics and outcome using different forms of therapies. A total of 183 (82.1%) underwent biopsy; 84 (45.9%) were Indian and 99 (54.1%) were black. Sixty-six (36.1%) had minimal change NS, 66 (36.1%) had focal segmental glomerulosclerosis (FSGS), 15 (8.2%) had a proliferative form of NS, and 36 (19.7%) had other forms of NS. Of the 84 Indian children biopsied, 58 (69.0%) were in complete remission, including 29 of 40 (72.5%) treated with oral cyclophosphamide and prednisone only. Of the 99 black children who were biopsied, 20 (20.2%) achieved complete remission; none of those treated with oral cyclophosphamide and prednisone only achieved complete remission. Of the 40 Indian children who were not biopsied who received only oral prednisone and cyclophosphamide, 32 (80%) achieved complete remission. This study shows Indian children with SRNS respond better to treatment than black children (69.0 vs. 20.2%). Since 80% of Indian children with SRNS responded to a trial of oral cyclophosphamide and prednisone, we propose the use of oral cyclophosphamide therapy in non-black children before embarking on renal biopsy.
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