Cyclosporin a in the therapy of nephrotic syndrome caused by focal-segmental glomerulosclerosis
Jovanović, D.; Kovacević, Z.; Rabrenović, V.
Vojnosanitetski Pregled 57(3): 303-307
2000
ISSN/ISBN: 0042-8450 PMID: 11039311 Document Number: 519540
The use of Cyclosporin A (CsA) in treatment nephrotic syndrome in the primary focal and segmental glomerulosclerosis (FSGS) is controversial. A prospective study was comprised of 10 adult patients with nephrotic syndrome caused by FSGS, treated with CsA and corticosteroids. Six patients were females, 4 males, aged 35 +/- 8 years. The daily urinary protein excretion ranged from 7 to 15 g/24 h (range 11.16 +/- 2.61 g/24 h). The follow-up interval lasted from 6-18 months. The serum CsA levels ranged from 80-120 ng/ml. Prednisone was administered orally 10-15 mg/day. Two months after the therapy onset, all patients experienced clinical improvement and reduction in the urinary daily protein excretion (range 9.74 +/- 2.14 g/24 h) with tendency to decrease, while a stable overall renal function was maintained. During 6 months, 6 patients were in remission (0.5 +/- 0.2 g/24 h), in two patients the proteinuria was retained 1.6-1.8 g/24 h and two patients had proteinuria 3.2-3.6 g/24 h. During the follow up period of this patients' group in the period of 18 months, the values of proteinuria were never above 3 g/24 h (1.15 +/- 0.9 g/24 h). These are encouraging results from initial treatment of FSGS with CsA and small doses prednisone.