ESPN 51th Annual Meeting

ESPN 2018


 
Corticoid sparing agents in pediatric steroid resistant nephrotic syndrome
ADRIAN CATALIN LUNGU 1 ANDREI CAPITANESCU 2 ALEXANDRA CORBU 1 CRISTINA STOICA 1

1- FUNDENI CLINICAL INSTITUTE
2- CLINICAL HOSPITAL OF NEPHROLOGY DR. CAROL DAVILA
 
Introduction:

Evaluate treatment regimens in pediatric patients with steroid-resistant nephrotic syndrome (SRNS).

Material and methods:

We performed an unicentric longitudinal retrospective study on a group of 69 patients aged under 18 years with nephrotic syndrome. After we applied the inclusion criteria - a diagnosis of SRNS, clinical and laboratory data available to document remission and relapses, treatment regimen administered and a follow-up of at least 12 months in our clinic, we analysed 14 patients. Patients received treatment with Cyclophosphamide (CYC) or Cyclosporin (CSA) associated with corticosteroids.

Results:

The median age at diagnosis was 2.66 years [1.87; 4.81], with male predominance 85.71%. The median baseline proteinuria, serum albumin and creatinine were 2.95 g/24 hours [0.95; 3.95], 2.25 g/dl [2; 3.12], 0,4 mg/dl [0.29; 0.52], respectively. The median time to remission was 1 month [1; 3] and the median time to treatment failure was 14.5 months [2.75; 22]. Analysis showed differences between treatment regimens, time for induction and time to treatment failure, but without statistical significance.

Conclusions:

This study suggests weak benefit of CYC for induction, and superiority of CSA for maintenance, with respect with what Hodson et al. observe in the most recent meta-analysis regarding this matter. Well-designed randomized clinical trials are needed to evaluate treatment regimens in pediatric SRNS.