Cyclosporin treatment for relapse and resistant Nephrotic Syndrome in adult
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Abstract
Nephrotic syndrome is common kidney disease. It was found that the recurrence rate was 50-60% after discontinuation of the drug within 1 year. Post-relapse treatment involves steroids and various immunosuppressants such as Cyclosporin to maintain disease remission. Evidence base study of relapse nephrotic syndrome in Thai adults was limited. Retrospective descriptive analysis from medical records associated with relapse and resistant nephrotic syndrome in adults over 15 years who received Cyclosporin was conducted to compare the efficacy of Cyclosporin in between complete remission and partial remission groups for significant factors affecting response and dosage. 64 patients with relapse and resistant nephrotic syndrome received Cyclosporin and were enrolled, mean age of 41.3 years (15-70 years). The response rate of Cyclosporin treatment at 12 weeks was 38 complete remissions (59.4%), and 26 partial remissions (40.6%) with a mean cyclosporin dose of 110.94 ± 43.1 mg/day (1.72 ± 0.68 mg/kg/day) in combination with a mean Diltiazem dose of 103.13 ± 59 mg/day. Factors affecting poor response to Cyclosporin were microscopic hematuria and urinary protein to creatinine ratio greater than 8. Cyclosporin has good efficacy for relapse and resistant nephrotic syndrome without serious side effects.
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