Methylprednisolone treatment in children with nephrotic primary focal segmental glomerulosclerosis

Objective: To examine the effectiveness of pulse methylprednisolone in children with nephrotic primary focal segmental glomerulosclerosis. Material and Method: Medical records of children, who were treated with a pulse methylprednisolone regimen for nephrotic syndrome resulting from primary focal se...

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Main Authors: Opastirakul S., Chartapisak W.
Format: Review
Language:English
Published: 2014
Online Access:http://www.scopus.com/inward/record.url?eid=2-s2.0-33845646442&partnerID=40&md5=bc2bf7fe0f9c786ffabf7a94695138d3
http://www.ncbi.nlm.nih.gov/pubmed/17214070
http://cmuir.cmu.ac.th/handle/6653943832/1981
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spelling th-cmuir.6653943832-19812014-08-30T02:00:20Z Methylprednisolone treatment in children with nephrotic primary focal segmental glomerulosclerosis Opastirakul S. Chartapisak W. Objective: To examine the effectiveness of pulse methylprednisolone in children with nephrotic primary focal segmental glomerulosclerosis. Material and Method: Medical records of children, who were treated with a pulse methylprednisolone regimen for nephrotic syndrome resulting from primary focal segmental glomerulosclerosis between 1987 and 2005, were retrospectively reviewed. The age,gender, urine protein, serum creatinine, and glomerular filtration rate at the onset of nephrotic syndrome were recorded. Urine protein, serum creatinine, glomerular filtration rate, and percentile of height before and after methylprednisolone treatment were compared. Results: There were six patients (4 male, 2 female) in the present report. The mean age at onset was 9.5 ± 2.2 years. Hypertension was noted in four patients and mild renal insufficiency in three. All patients had nephrotic-ranged proteinuria at onset and they were initially treated with prednisolone. Two were steroid-dependent and four were steroid-resistant. All of the steroid resistant cases were also resistant to oral cyclophosphamide. After methylprednisolone treatment, remission of proteinuria was noted in five patients (83%) (2 complete, 3 partial). Mean duration to remission was 20.8 weeks. There were no significant changes in serum creatinine (p = 0.43), GFR (p = 0.78) and percentile of height before and after treatment. No hypertension or cardiac arrhythmia was detected during methylprednisolone administration. The follow-up period after completion of the methylprednisolone regimen was 19.5 ± 15.2 months (range 4-36 months). The clinical course of five patients with remission was characterized by sustained remission in three patients. Two patients relapsed at 2 and 8 months after treatment. Conclusion: Methylprednisolone was effective and safe in treating nephrotic children with primary focal segmental glomerulosclerosis. There was a high incidence of relapse shortly after the cessation of treatment. However, a larger number of patients and longer period of follow-up are needed to confirm this conclusion. 2014-08-30T02:00:20Z 2014-08-30T02:00:20Z 2006 Review 01252208 17214070 JMTHB http://www.scopus.com/inward/record.url?eid=2-s2.0-33845646442&partnerID=40&md5=bc2bf7fe0f9c786ffabf7a94695138d3 http://www.ncbi.nlm.nih.gov/pubmed/17214070 http://cmuir.cmu.ac.th/handle/6653943832/1981 English
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
language English
description Objective: To examine the effectiveness of pulse methylprednisolone in children with nephrotic primary focal segmental glomerulosclerosis. Material and Method: Medical records of children, who were treated with a pulse methylprednisolone regimen for nephrotic syndrome resulting from primary focal segmental glomerulosclerosis between 1987 and 2005, were retrospectively reviewed. The age,gender, urine protein, serum creatinine, and glomerular filtration rate at the onset of nephrotic syndrome were recorded. Urine protein, serum creatinine, glomerular filtration rate, and percentile of height before and after methylprednisolone treatment were compared. Results: There were six patients (4 male, 2 female) in the present report. The mean age at onset was 9.5 ± 2.2 years. Hypertension was noted in four patients and mild renal insufficiency in three. All patients had nephrotic-ranged proteinuria at onset and they were initially treated with prednisolone. Two were steroid-dependent and four were steroid-resistant. All of the steroid resistant cases were also resistant to oral cyclophosphamide. After methylprednisolone treatment, remission of proteinuria was noted in five patients (83%) (2 complete, 3 partial). Mean duration to remission was 20.8 weeks. There were no significant changes in serum creatinine (p = 0.43), GFR (p = 0.78) and percentile of height before and after treatment. No hypertension or cardiac arrhythmia was detected during methylprednisolone administration. The follow-up period after completion of the methylprednisolone regimen was 19.5 ± 15.2 months (range 4-36 months). The clinical course of five patients with remission was characterized by sustained remission in three patients. Two patients relapsed at 2 and 8 months after treatment. Conclusion: Methylprednisolone was effective and safe in treating nephrotic children with primary focal segmental glomerulosclerosis. There was a high incidence of relapse shortly after the cessation of treatment. However, a larger number of patients and longer period of follow-up are needed to confirm this conclusion.
format Review
author Opastirakul S.
Chartapisak W.
spellingShingle Opastirakul S.
Chartapisak W.
Methylprednisolone treatment in children with nephrotic primary focal segmental glomerulosclerosis
author_facet Opastirakul S.
Chartapisak W.
author_sort Opastirakul S.
title Methylprednisolone treatment in children with nephrotic primary focal segmental glomerulosclerosis
title_short Methylprednisolone treatment in children with nephrotic primary focal segmental glomerulosclerosis
title_full Methylprednisolone treatment in children with nephrotic primary focal segmental glomerulosclerosis
title_fullStr Methylprednisolone treatment in children with nephrotic primary focal segmental glomerulosclerosis
title_full_unstemmed Methylprednisolone treatment in children with nephrotic primary focal segmental glomerulosclerosis
title_sort methylprednisolone treatment in children with nephrotic primary focal segmental glomerulosclerosis
publishDate 2014
url http://www.scopus.com/inward/record.url?eid=2-s2.0-33845646442&partnerID=40&md5=bc2bf7fe0f9c786ffabf7a94695138d3
http://www.ncbi.nlm.nih.gov/pubmed/17214070
http://cmuir.cmu.ac.th/handle/6653943832/1981
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