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Erschienen in: Pediatric Nephrology 6/2011

01.06.2011 | Original Article

Cyclophosphamide in steroid-dependent nephrotic syndrome

verfasst von: Sonia Azib, Marie Alice Macher, Theresa Kwon, Agnes Dechartres, Corinne Alberti, Chantal Loirat, Georges Deschênes, Véronique Baudouin

Erschienen in: Pediatric Nephrology | Ausgabe 6/2011

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Abstract

In order to determine the long-term effects of cyclophosphamide (CPO) and to identify parameters associated with sustained remission, we retrospectively studied the data from 90 patients with steroid-dependent nephrotic syndrome (SDNS) who received a single course of oral cyclophosphamide (2 mg/kg/day for 10 to 12 weeks). The median follow-up period after CPO was 5.5 years (interquartile range 3.2–8.5). Sustained remission reached the cumulative rate of 57% at 1 year, 42% at 2 years, and 31% at 5 years. For the patients who relapsed, the median threshold dose of prednisone between CPO initiation and first relapse has significantly decreased (22.1 mg/kg/day versus 4.9 mg/kg/day, p < 0.001). No further immunosuppressive agent was required in 60% of all patients. Young age at CPO initiation was associated with a lower rate of sustained remission (p < 0.001). Age at diagnosis of nephrotic syndrome, gender, cumulative dose of CPO (in mg/kg), and level of steroid dependence at CPO initiation did not influence the outcome. The incidence of side effects was low. These findings suggest that despite the wide use of new immunosuppressive agents, a short course of CPO remains an effective second-line therapy in SDNS patients. Optimal efficiency was observed in children over 7.5 years.
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Metadaten
Titel
Cyclophosphamide in steroid-dependent nephrotic syndrome
verfasst von
Sonia Azib
Marie Alice Macher
Theresa Kwon
Agnes Dechartres
Corinne Alberti
Chantal Loirat
Georges Deschênes
Véronique Baudouin
Publikationsdatum
01.06.2011
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Nephrology / Ausgabe 6/2011
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-011-1830-0

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