| Autor: |
D C, Cattran, G B, Appel, L A, Hebert, L G, Hunsicker, M A, Pohl, W E, Hoy, D R, Maxwell, C L, Kunis |
| Rok vydání: |
1999 |
| Předmět: |
|
| Zdroj: |
Kidney international. 56(6) |
| ISSN: |
0085-2538 |
| Popis: |
A randomized trial of cyclosporine in patients with steroid-resistant focal segmental glomerulosclerosis.A clinical trial of cyclosporine in patients with steroid-resistant focal segmental glomerulosclerosis (FSGS) was conducted. Despite the fact that it is the most common primary glomerulonephritis to progress to renal failure, treatment trials have been very limited.We conducted a randomized controlled trial in 49 cases of steroid-resistant FSGS comparing 26 weeks of cyclosporine treatment plus low-dose prednisone to placebo plus prednisone. All patients were followed for an average of 200 weeks, and the short- and long-term effects on renal function were assessed.Seventy percent of the treatment group versus 4% of the placebo group (P0. 001) had a partial or complete remission of their proteinuria by 26 weeks. Relapse occurred in 40% of the remitters by 52 weeks and 60% by week 78, but the remainder stayed in remission to the end of the observation period. Renal function was better preserved in the cyclosporine group. There was a decrease of 50% in baseline creatinine clearance in 25% of the treated group compared with 52% of controls (P0.05). This was a reduction in risk of 70% (95% CI, 9 to 93) independent of other baseline demographic and laboratory variables.These results suggest that cyclosporine is an effective therapeutic agent in the treatment of steroid-resistant cases of FSGS. Although a high relapse rate does occur, a long-term decrease in proteinuria and preservation of filtration function were observed in a significant proportion of treated patients. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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