Immunosuppressive therapy of childhood idiopathic nephrotic syndrome.

Abstract

Childhood nephrotic syndrome (NS) is a distressing chronic renal disorder with potentially life threatening complications. Over 80% of cases in children are due to minimal change disease and the majority will respond to corticosteroid therapy. Steroid-sensitive NS is considered a relatively benign condition, since progression to end stage renal failure (ESRF) is extremely rare and > 80% will enter spontaneous long-term remission in later childhood. However, the disease is characterised by a relapsing course, placing the child at risk of acute complications, such as infection, hypovolaemia and thrombosis. Frequent relapses can result in a not inconsequential corticosteroid burden or prescription of cytotoxic immunosuppressive therapy to control the disease. In contrast, steroid-resistant and -refractory NS has an unfavourable outcome with a propensity to progress to ESRF. While these clinical entities have an unpredictable response to cytotoxic immunosuppressive therapy, the favourable long-term renal survival associated with children who enter sustained remission has revived the enthusiasm to treat steroid-resistant NS with more aggressive immunosuppressive regimens.

• Authors: A Abeyagunawardena, Paul A Brogan, R S Trompeter, Matthew J Dillon
• Journal: Expert opinion on pharmacotherapy (Expert Opin Pharmacother) Vol. 3 Issue 5 Pg. 513-9 (May 2002) ISSN: 1465-6566 [Print] England
• PMID: 11996630 (Publication Type: Journal Article, Review)

Chemical References

• Adrenal Cortex Hormones
• Immunosuppressive Agents

Topics

• Adrenal Cortex Hormones (adverse effects, therapeutic use)
• Child
• Child, Preschool
• Humans
• Immunosuppressive Agents (adverse effects, therapeutic use)
• Kidney Failure, Chronic (etiology)
• Nephrotic Syndrome (complications, drug therapy, physiopathology)