Cyclosporine A induced remission of relapsing nephrotic syndrome in children

A. Tejani, K. Butt, H. Trachtman, M. Suthanthiran, C. J. Rosenthal, M. R. Khawar

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Abstract

We treated 20, steroid resistant or steroid dependent and cyclophosphamide or chlorambucil treated, relapsing nephrotic patients with oral cyclosporine A for eight weeks. Cyclosporine A was started at 7 mg/kg/day and titrated to maintain HPLC level of 100 to 200 ng/ml. Of 20 patients, 14 had a complete remission and the remaining 6 had a reduction in their proteinuria. The mean serum albumin of the 14 responders rose from 2.1 g/dl to 4.1 g/dl (P < 0.00001) after cyclosporine A therapy. The mean serum cholesterol of the 14 responders decreased from 394 mg/dl to 184 mg/dl (P < 0.0001) after cyclosporine A therapy. The mean creatinine clearance of the 20 patients (104 ml/min/1.73 m2) was unchanged (107 ml/min/1.73 m2) after eight weeks of cyclosporine A. By life table analysis, 40% of the responders show a sustained remission of up to a year. Cyclosporine A responders had a higher T3 cell count prior to therapy compared to nonresponders (69 ± 5.54% vs. 61 ± 6.4%, P < 0.02). Pre-therapy interleukin-2 levels measured in 10 patients were normal or supranormal in 8, 6 of whom were treatment responders. Two patients with low interleukin-2 levels were nonresponders. Cyclosporine A can be used to induce a remission in relapsing nephrotic patients, and short-term cyclosporine A therapy does not produce nephrotoxicity.

Original languageEnglish
Pages (from-to)729-734
Number of pages6
JournalKidney International
Volume33
Issue number3
DOIs
Publication statusPublished - 1 Jan 1988

ASJC Scopus subject areas

  • Nephrology

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    Tejani, A., Butt, K., Trachtman, H., Suthanthiran, M., Rosenthal, C. J., & Khawar, M. R. (1988). Cyclosporine A induced remission of relapsing nephrotic syndrome in children. Kidney International, 33(3), 729-734. https://doi.org/10.1038/ki.1988.59