Cyclosporine effectiveness and adverse outcomes in steroid dependent and frequent relapsing nephrotic syndrome in children | ||
| Sohag Medical Journal | ||
| Volume 28, Issue 2, 2024, Pages 55-63 PDF (854.17 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/smj.2024.264014.1445 | ||
| Authors | ||
| Ghada Ashry Borham1; Mahmoud T.M. Abd El-aal2; mustafa abo-sdera3; Rania Gamal Abdelatif* 4 | ||
| 1Pediatric department Sohag Faculty of medicine Sohag University | ||
| 2Pediatric department, Faculty of Medicine, Sohag university | ||
| 3Department of Pediatrics, Faculty of Medicine – Sohag University, Sohag | ||
| 4Pediatric department, Faculty of Medicine, Sohag University, Egypt | ||
| Abstract | ||
| Background: Cyclosporine is a calcineurin inhibitor that exhibits a notable steroid-sparing effect in patients with steroid-dependent nephrotic syndrome or those experiencing frequent relapses. Despite long-term cyclosporine use, it has been linked to an increased risk of unpleasant side effects, including nephrotoxicity, hypertension, and cosmetic symptoms like hirsutism and gum hypertrophy. Aim: To assess effectiveness and side effects of cyclosporine in children diagnosed with steroid-dependent and frequent relapsing nephrotic syndrome at Sohag University Hospital. Methods: We conducted a combined prospective and retrospective study at Pediatric nephrology clinic, Sohag University Hospital on children and adolescents diagnosed as steroid-dependent and frequent relapsing nephrotic syndrome who received cyclosporine as a steroid sparing agent. Results: This study included total 50 nephrotic patients, there mean age was 11.4 ± 3.1 (4-15) years. Male: female ratio was 2.8:1. The mean disease duration was 7.0 ± 3.5 (1.3-14) years, and the mean cyclosporine use duration was 4.0 ± 2.6 (1-11) years. The average relapse number/patient/year significantly decreased by 82.6% following cyclosporine treatment, and the mean dependent steroid dose decreased by 69.19%.The recorded cyclosporine side effects were: hirsutism in 94%, gum hyperplasia in 38%, gastrointestinal disturbances in 32%, nephrotoxicity in 28% and new onset hypertension in 26% of cases. Histological nephrotoxicity was evident in 14 individuals (35.9%) of biopsied children. Conclusion: Cyclosporine is deemed both safe and efficacious as a steroid-sparing medication for individuals with steroid-dependent and frequent relapsing nephrotic syndrome. Nonetheless, the safety of cyclosporine is not without exceptions, and various levels of side effects have been documented. | ||
| Keywords | ||
| Calcinurin inhibitor; side effects; steriod dependency | ||
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