ArticlePediatric nephrology (Berlin, Germany)2009
Experience with tacrolimus in children with steroid-resistant nephrotic syndrome.
Article in Pediatric nephrology (Berlin, Germany), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Clinical practice guideline for pediatric idiopathic nephrotic syndrome 2013: medical therapy.Clinical and experimental nephrology · 2015Guideline
- Pooled it
- Population pharmacokinetics of tacrolimus in children with nephrotic syndrome.British journal of clinical pharmacology · 2018Trial
- Novel multidrug therapy for children with cyclosporine-resistant or -intolerant nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2011Trial
- Efficacy of Calcineurin Inhibition in Children With Steroid-Resistant Nephrotic Syndrome.Kidney international reports · 2025Article
- Steroid-Induced Psychosis in a Child With Nephrotic Syndrome Secondary to Focal Segmental Glomerulosclerosis: A Case Report.Clinical case reports · 2024Article
- Efficacy and safety of tacrolimus and low-dose prednisone in Chinese children with steroid-resistant nephrotic syndrome.World journal of pediatrics : WJP · 2020Article
- Off-label use of tacrolimus in children with glomerular disease: Effectiveness, safety and pharmacokinetics.British journal of clinical pharmacology · 2020Review
- Effect of CYP3 A4, CYP3 A5 and ABCB1 gene polymorphisms on the clinical efficacy of tacrolimus in the treatment of nephrotic syndrome.BMC pharmacology & toxicology · 2018Article
- Calcineurin inhibitors and nephrotoxicity in children.World journal of pediatrics : WJP · 2018Review
- Clinical efficacy and pharmacokinetics of tacrolimus in children with steroid-resistant nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2015Article
- Use of Cyclosporine Therapy in Steroid Resistant Nephrotic Syndrome (SRNS): A Review.Global journal of health science · 2015Review
- C1q nephropathy in the setting of granulomatosis with polyangiitis treated with tacrolimus.Clinical kidney journal · 2014Article
- Efficacy of tacrolimus in the treatment of children with focal segmental glomerulosclerosis.World journal of pediatrics : WJP · 2014Article
- Second-line immunosuppressive treatment of childhood nephrotic syndrome: a single-center experience.Nephron extra · 2014Article
- Calcineurin inhibitor induced nephrotoxicity in steroid resistant nephrotic syndrome.Indian journal of nephrology · 2013Article
- Treatment of tacrolimus or cyclosporine A in children with idiopathic nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2012Article
- New therapies in steroid-sensitive and steroid-resistant idiopathic nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2011Review
- Long-term outcome of children with steroid-resistant nephrotic syndrome treated with tacrolimus.Pediatric nephrology (Berlin, Germany) · 2010Article
- Rituximab, Mycophenolic Acid, and Calcineurin Inhibitors Achieve Long-Term Remission in Pediatric Focal Segmental Glomerulosclerosis with Steroid-Resistant and Frequently Relapsing Nephrotic Syndrome: A Report of Two Cases.Case reports in nephrology and dialysisArticle
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Children with steroid-resistant nephrotic syndrome (SRNS) are at risk of developing renal failure. We report here the results of a single-center retrospective observational study of the remission rate in pediatric patients with SNRS receiving tacrolimus. Serial renal biopsies from children on tacrolimus therapy were evaluated for tubulointerstitial fibrosis and transforming growth factor-beta immunostaining. Of the 16 children with SRNS, 15 went into complete remission after a median of 120 days of therapy. Nine children were able to stop steroids, while the others were on tapering doses. Forty-seven percent had relapses, most of which were steroid-responsive. Serial renal biopsies were obtained from seven children after a median treatment duration of 24 months; two of these children had increased tubulointerstitial fibrosis and four showed increased transforming growth factor-beta tissue staining. Children with worsening histological findings were younger. There was no significant association between tacrolimus exposure and biopsy changes, although the average trough level was higher in those children with worsening histological findings. In conclusion, tacrolimus may be a safe and effective alternative agent for inducing remission in children with SRNS. However, caution needs to be taken when prescribing this agent due to its narrow therapeutic index. Serial renal biopsies are necessary to check for subclinical nephrotoxicity, especially in younger children and those with higher trough levels.
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Registered trials
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.