Treatment Strategies for Childhood Steroid-Resistant Nephrotic Syndrome.
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Date
2013-10
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Abstract
Background: Nephrotic syndrome (NS) is a common childhood kidney disease caused
by impaired glomerular function, characterized by protein leakage from the blood to the
urine through the glomeruli, resulting in proteinuria, hypoalbuminemia,
hypercholesterolemia and generalized edema. NS is descriptively classified upon the
patients’ response to steroid treatment as steroid-sensitive NS (SSNS) or steroidresistant
NS (SRNS).
Aim: describe and compare different management strategies for SRNS.
Methods: This retrospective study included 53 SRNS who were attending the
Nephrology Outpatient Clinic, Children's Hospital, and Cairo University for follow-up.
Results: out of 53 SRNS patients, 29 (54.72%) patients showed complete response to
immunosuppressive therapy, while 14 (25.42%) showed partial response and the
remaining 10 (18.87%) showed no response.
Conclusion: Partial response to steroids or to first line of immunosuppressive therapy
predicts better response to further immunosuppressives in SRNS patient.
Cyclophosphamide is a preferable line in MCNS as it gives good results (50% complete
response) with the advantage of lower cost and shorter duration of use. In patients with non-minimal change lesions or those who failed to respond to cyclophosphamide,
cyclosporine is used.
Description
Keywords
Nephrotic syndrome, steroid-sensitive nephrotic syndrome, steroid-resistant, nephrotic syndrome, children
Citation
Talaat Hala Salah El-Din, Sabry Samar, Mohammed Mohammed Farouk, Ayad Ashraf. Treatment Strategies for Childhood Steroid-Resistant Nephrotic Syndrome. British Journal of Medicine and Medical Research. 2013 Oct-Dec; 3(4): 1074-1086.