الفهرس | Only 14 pages are availabe for public view |
Abstract This study reports the results of CsA treatment in 207 patients with INS of whom 175 were children. One hundred and eight were steroid-dependent. The underlying pathology was focal segmental glomerulosclerosis (FSGS), minimal change disease (MCD), diffuse mesangial proliferation (DMP), membranous nephropathy (MN) and membranoproliferative glomerulonephritis (MPGN) in 126, 48, 15, 10 and 8 patients respectively. All patients had normal renal function before CsA therapy. CsA induced complete remission in 137 (66.2%) and partial remission in 17 (8.2%). The rest of patients were resistant to therapy. Response to CsA was significantly better in: children compared with adults (p = .04); steroid dependent patients versus steroid resistant ones (p = .001); MCD, DMP and FSGS compared with other pathological lesions (p = .003) and in those who had lower quantities of pre-treatment proteinuria (p = .02). CsA was received for a period of 22.16 + 12.21 (6-72) months. Discontinuation of the drug in 37 patients resulted in relapse in 73% while the remaining 27% maintained remission until the last follow up (11.1 + 5.3 months). Eighteen out of 26 patients showed complete remission when CsA was resumed. Renal dysfunction (serum creatinine) developed in 17 patients (8.2%) of whom 11 recovered completely on drug discontinuation. Hypertension developed in 36 (17.4%) patients while hypertrichosis 108 (52.2%) and gum hyperplasia 51(24.6%) were the most frequent CsA-related side effects. We conclude that CsA is generally effective in the treatment of INS. Renal dysfunction and hypertension may be CsA- induced or due to disease progression. |