High Response and Relapse Rate in Cyclosporine-Treated Minimal Change Disease and Focal Segmental Glomerulosclerosis in Taiwanese Patients

Ying Kuang Lin, I. Wen Wu, Yung Chih Chen, Chiao Ying Sun, Wei Liu, Mai-Szu Wu

Research output: Contribution to journalArticle

Abstract

Background: Cyclosporine (CsA) is used in steroid-resistant and dependent minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS). The clinical experience is limited in Taiwanese patients who received a low dose of CsA combined with corticosteroid. Materials and Methods: We conducted a retrospective case series study of biopsy-proven MCD (15 patients) and FSGS (7 patients) with CsA treatment between 2004 and 2007. CsA therapy was used in steroid-resistant (SR) or steroid-dependent (SD) patients. The treatment protocol consisted of CsA 3 mg/Kg/day and prednisolone 10 mg/day. The clinical features, outcome, and adverse effects were assessed in detail. Results: Twenty-two patients received CsA therapy during the study period. Seventeen patients (77.3%) were steroid dependent (SD) and five patients (22.7%) were steroid-resistant (SR). In the MCD group, CsA therapy induced remission in eleven patients (73%). The mean duration for CsA-responsiveness was 5.0±1.8 weeks. Out of seven patients who withdrew from CsA, six patients (85.7%) relapsed wit/tin 20.2±4.1 weeks. The experience in the FSGS group was similar. The mean time to ac/sieve CsA-responsiveness was 4.6±2.7 weeks. Four of four patients (100%) relapsed within 18.6±6.2 weeks. Previous ”steroid responsiveness” was the most powerful predictor of a favorable CsA response (P<0.05). Hypertrichosis, gum hypertrophy, hypertension, and transient hyperkalemia occurred in 50%, 27.2%, 9.1%, and 4.5% of patients, respectively. No patient developed renal dysfunction in the observation period. Conclusion: A low dose of CsA combined with corticosteroid is effective and safe for treatment of SD/SR patients with MCD and FSGS in Taiwan. However the relapse rate remains high after withdrawal of CsA.
Original languageEnglish
Pages (from-to)111-116
Number of pages6
JournalActa Nephrologica
Volume22
Issue number2
Publication statusPublished - 2008
Externally publishedYes

Fingerprint

Lipoid Nephrosis
Focal Segmental Glomerulosclerosis
Cyclosporine
Recurrence
Steroids
Adrenal Cortex Hormones
Hypertrichosis
Therapeutics
Wit and Humor
Hyperkalemia
Tin
Gingiva
Clinical Protocols
Prednisolone
Taiwan

Keywords

  • 環孢靈
  • 微細病變
  • 局部性腎絲球硬化症
  • 台灣人
  • Cyclosporine
  • minimal change disease
  • focal segmental glomerulo-sclerosis
  • Taiwanese

Cite this

High Response and Relapse Rate in Cyclosporine-Treated Minimal Change Disease and Focal Segmental Glomerulosclerosis in Taiwanese Patients. / Lin, Ying Kuang; Wu, I. Wen; Chen, Yung Chih; Sun, Chiao Ying; Liu, Wei; Wu, Mai-Szu.

In: Acta Nephrologica, Vol. 22, No. 2, 2008, p. 111-116.

Research output: Contribution to journalArticle

Lin, Ying Kuang ; Wu, I. Wen ; Chen, Yung Chih ; Sun, Chiao Ying ; Liu, Wei ; Wu, Mai-Szu. / High Response and Relapse Rate in Cyclosporine-Treated Minimal Change Disease and Focal Segmental Glomerulosclerosis in Taiwanese Patients. In: Acta Nephrologica. 2008 ; Vol. 22, No. 2. pp. 111-116.
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abstract = "Background: Cyclosporine (CsA) is used in steroid-resistant and dependent minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS). The clinical experience is limited in Taiwanese patients who received a low dose of CsA combined with corticosteroid. Materials and Methods: We conducted a retrospective case series study of biopsy-proven MCD (15 patients) and FSGS (7 patients) with CsA treatment between 2004 and 2007. CsA therapy was used in steroid-resistant (SR) or steroid-dependent (SD) patients. The treatment protocol consisted of CsA 3 mg/Kg/day and prednisolone 10 mg/day. The clinical features, outcome, and adverse effects were assessed in detail. Results: Twenty-two patients received CsA therapy during the study period. Seventeen patients (77.3{\%}) were steroid dependent (SD) and five patients (22.7{\%}) were steroid-resistant (SR). In the MCD group, CsA therapy induced remission in eleven patients (73{\%}). The mean duration for CsA-responsiveness was 5.0±1.8 weeks. Out of seven patients who withdrew from CsA, six patients (85.7{\%}) relapsed wit/tin 20.2±4.1 weeks. The experience in the FSGS group was similar. The mean time to ac/sieve CsA-responsiveness was 4.6±2.7 weeks. Four of four patients (100{\%}) relapsed within 18.6±6.2 weeks. Previous ”steroid responsiveness” was the most powerful predictor of a favorable CsA response (P<0.05). Hypertrichosis, gum hypertrophy, hypertension, and transient hyperkalemia occurred in 50{\%}, 27.2{\%}, 9.1{\%}, and 4.5{\%} of patients, respectively. No patient developed renal dysfunction in the observation period. Conclusion: A low dose of CsA combined with corticosteroid is effective and safe for treatment of SD/SR patients with MCD and FSGS in Taiwan. However the relapse rate remains high after withdrawal of CsA.",
keywords = "環孢靈, 微細病變, 局部性腎絲球硬化症, 台灣人, Cyclosporine, minimal change disease, focal segmental glomerulo-sclerosis, Taiwanese",
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TY - JOUR

T1 - High Response and Relapse Rate in Cyclosporine-Treated Minimal Change Disease and Focal Segmental Glomerulosclerosis in Taiwanese Patients

AU - Lin, Ying Kuang

AU - Wu, I. Wen

AU - Chen, Yung Chih

AU - Sun, Chiao Ying

AU - Liu, Wei

AU - Wu, Mai-Szu

PY - 2008

Y1 - 2008

N2 - Background: Cyclosporine (CsA) is used in steroid-resistant and dependent minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS). The clinical experience is limited in Taiwanese patients who received a low dose of CsA combined with corticosteroid. Materials and Methods: We conducted a retrospective case series study of biopsy-proven MCD (15 patients) and FSGS (7 patients) with CsA treatment between 2004 and 2007. CsA therapy was used in steroid-resistant (SR) or steroid-dependent (SD) patients. The treatment protocol consisted of CsA 3 mg/Kg/day and prednisolone 10 mg/day. The clinical features, outcome, and adverse effects were assessed in detail. Results: Twenty-two patients received CsA therapy during the study period. Seventeen patients (77.3%) were steroid dependent (SD) and five patients (22.7%) were steroid-resistant (SR). In the MCD group, CsA therapy induced remission in eleven patients (73%). The mean duration for CsA-responsiveness was 5.0±1.8 weeks. Out of seven patients who withdrew from CsA, six patients (85.7%) relapsed wit/tin 20.2±4.1 weeks. The experience in the FSGS group was similar. The mean time to ac/sieve CsA-responsiveness was 4.6±2.7 weeks. Four of four patients (100%) relapsed within 18.6±6.2 weeks. Previous ”steroid responsiveness” was the most powerful predictor of a favorable CsA response (P<0.05). Hypertrichosis, gum hypertrophy, hypertension, and transient hyperkalemia occurred in 50%, 27.2%, 9.1%, and 4.5% of patients, respectively. No patient developed renal dysfunction in the observation period. Conclusion: A low dose of CsA combined with corticosteroid is effective and safe for treatment of SD/SR patients with MCD and FSGS in Taiwan. However the relapse rate remains high after withdrawal of CsA.

AB - Background: Cyclosporine (CsA) is used in steroid-resistant and dependent minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS). The clinical experience is limited in Taiwanese patients who received a low dose of CsA combined with corticosteroid. Materials and Methods: We conducted a retrospective case series study of biopsy-proven MCD (15 patients) and FSGS (7 patients) with CsA treatment between 2004 and 2007. CsA therapy was used in steroid-resistant (SR) or steroid-dependent (SD) patients. The treatment protocol consisted of CsA 3 mg/Kg/day and prednisolone 10 mg/day. The clinical features, outcome, and adverse effects were assessed in detail. Results: Twenty-two patients received CsA therapy during the study period. Seventeen patients (77.3%) were steroid dependent (SD) and five patients (22.7%) were steroid-resistant (SR). In the MCD group, CsA therapy induced remission in eleven patients (73%). The mean duration for CsA-responsiveness was 5.0±1.8 weeks. Out of seven patients who withdrew from CsA, six patients (85.7%) relapsed wit/tin 20.2±4.1 weeks. The experience in the FSGS group was similar. The mean time to ac/sieve CsA-responsiveness was 4.6±2.7 weeks. Four of four patients (100%) relapsed within 18.6±6.2 weeks. Previous ”steroid responsiveness” was the most powerful predictor of a favorable CsA response (P<0.05). Hypertrichosis, gum hypertrophy, hypertension, and transient hyperkalemia occurred in 50%, 27.2%, 9.1%, and 4.5% of patients, respectively. No patient developed renal dysfunction in the observation period. Conclusion: A low dose of CsA combined with corticosteroid is effective and safe for treatment of SD/SR patients with MCD and FSGS in Taiwan. However the relapse rate remains high after withdrawal of CsA.

KW - 環孢靈

KW - 微細病變

KW - 局部性腎絲球硬化症

KW - 台灣人

KW - Cyclosporine

KW - minimal change disease

KW - focal segmental glomerulo-sclerosis

KW - Taiwanese

M3 - Article

VL - 22

SP - 111

EP - 116

JO - Acta Nephrologica

JF - Acta Nephrologica

SN - 1013-1671

IS - 2

ER -