Comparison of therapeutic effects of prednisone combined with mycophenolate mofetil versus cyclosporin A in children with steroid-resistant nephrotic syndrome
LI Zhi-Hui, LIN Zhi, DUAN Cui-Rong, WU Tian-Hui, XUN Mai, ZHANG Yi, ZHANG Liang, DING Yun-Feng, YIN Yan
College of Pediatrics, University of South China/Children's Hospital of Hunan Province, Changsha 410007, China
Abstract Objective To compare the therapeutic effects of prednisone combined with mycophenolate mofetil(MMF) versus cyclosporin A(CsA) in children with steroid-resistant nephrotic syndrome(SRNS).Methods The clinical data of 164 SRNS children who were treated with prednisone combined with MMF or CsA between January 2004 and December 2013 were collected, and the clinical effect of prednisone combined with MMF(MMF group, 112 children) or CsA(CsA group, 52 children) was analyzed retrospectively.Results At 1 month after treatment, the CsA group had a significantly higher remission rate than the MMF group(67.3% vs 42.9%;PPPPConclusions Prednisone combined with MMF or CsA is effective and safe for the treatment of SRNS in children, and within 3 months of treatment, CsA has a better effect than MMF.
LI Zhi-Hui,LIN Zhi,DUAN Cui-Rong et al. Comparison of therapeutic effects of prednisone combined with mycophenolate mofetil versus cyclosporin A in children with steroid-resistant nephrotic syndrome[J]. CJCP, 2016, 18(2): 130-135.
LI Zhi-Hui,LIN Zhi,DUAN Cui-Rong et al. Comparison of therapeutic effects of prednisone combined with mycophenolate mofetil versus cyclosporin A in children with steroid-resistant nephrotic syndrome[J]. CJCP, 2016, 18(2): 130-135.
Cammas B, Harambat J, Bertholet-Thomas A, et al. Long-term effects of cyclophosphamide therapy in steroid-dependent or frequently relapsing idiopathic nephrotic syndrome[J]. Nephrol Dial Transplant, 2011, 26(1):178-184.
[4]
Beck L, Bomback AS, Choi MJ, et al. KDOQI US Commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis[J]. Am J Kidney Dis, 2013, 62(3):403-441.
[5]
Moudgil A, Bagga A, Jordan SC. Mycophenolate mofetil therapy in frequently relapsing steroid-dependent and steroid——resistant nephrotic syndrome of childhood:current status and future directions[J]. Pediatr Nephrol, 2005, 20(10):1376-1381.
[6]
Gellermann J, Weber L, Pape L, et al. Mycophenolate mofetil versus cyclosporin A in children with frequently relapsing nephrotic syndrome[J]. J Am Soc Nephrol, 2013, 24(10):1689-1697.
Al Salloum AA, Muthanna A, Bassrawi R, et al. Long-term outcome of the difficult nephrotic syndrome in children[J]. Saudi J Kidney Dis Transpl, 2012, 23(5):965-972.
Meyrier A, Simon P, Perret G, et al. Remission of idiopathic nephrotic syndrome after treatment with cyclosporin[J]. Br Med J(Clin Res Ed), 1986, 292(6523):789-792.
[13]
Eiske M, Elena N, Albert J, et al. Mycophenolate mofetil versus cyclosporine for remission maintenance in nephrotic syndrome[J]. Pediatr Nephrol, 2008, 23(11):2013-2020.
[14]
Segarra Medrano A, Vila Presas J, Pou Clavé L, et al. Efficacy and safety of combined cyclosporin A and mycophenolate mofetil therapy in patients with cyclosporin-resistant focal segmental glomerulosclerosis[J]. Nefrologia, 2011, 31(3):286-291.
[15]
Gulati S, Saha A. Factors predietive of remission in steroid resistant nephrotic syndrome in children:a multivariate analysis[J]. Indian Pediatr, 2007, 44(5):395-396.
[16]
Ehrich JHH, Geerlings C, Zivicnjak M, et al. Steroidresistant idiopathic childhood nephrosis:overdiagnosed and undertreated[J]. Nephrol Dial Transplant,2007, 22(8):2183-2193.
[17]
Echeverri CV, Valencia GA, Higuita LM, et al. Immunosupressive therapy in children with steroid-resistant nephrotic syndrome:single center experience[J]. J Bras Nefrol, 2013, 35(3):200-205.
