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- Title
High-dose mizoribine therapy for childhood-onset frequently relapsing steroid-dependent nephrotic syndrome with cyclosporin nephrotoxicity.
- Authors
Ohtomo, Yoshiyuki; Fujinaga, Shu-ichiro; Takada, Masaru; Murakami, Hitohiko; Akashi, Shunji; Shimizu, Toshiaki; Kaneko, Kazunari; Yamashiro, Yuichiro
- Abstract
Cyclosporin A (CsA) is an effective treatment for frequently relapsing steroid-dependent nephrotic syndrome (FR-SDNS), but its use can be complicated by renal toxicity and a high incidence of relapses after withdrawal. We report 9 adolescent patients with childhood-onset FR-SDNS who had been treated with long-term CsA that resulted in moderate-to-severe CsA nephropathy (CsAN). They were treated with high-dose (mean: 10.1 mg/kg per day) mizoribine (MZR) in an attempt to allow weaning of CsA and/or steroid therapy, and reduce the frequency of relapses. Seven out of 9 patients were weaned off CsA by 1-year follow-up, although in the remaining 2 patients, MZR did not show any beneficial effects. Overall, this high-dose MZR therapy results in significant steroid sparing and reduction in relapse rates in our patients. Our experience shows that high-dose MZR therapy in patients with FR-SDNS who are also CsA-dependent appears to be effective in reducing CsA exposure as well as in decreasing the frequency of relapses.
- Subjects
NEPHROTIC syndrome in children; PEDIATRIC nephrology; NEPHROTIC syndrome; CYCLOSPORINE; NEPHROTOXICOLOGY; PATIENTS; STEROID drugs; KIDNEY diseases
- Publication
Pediatric Nephrology, 2005, Vol 20, Issue 12, p1744
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-005-2025-3