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 journalArticlepeer-review

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.
Translated title of the contribution環抱靈應用於台灣病人罹患微細病變及局部性腎絲球硬化症之高反應與高復發率之特性
Original languageEnglish
Pages (from-to)111-116
Number of pages6
JournalActa Nephrologica
Volume22
Issue number2
Publication statusPublished - 2008
Externally publishedYes

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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