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https://repositorio.ufba.br/handle/ri/4801
metadata.dc.type: | Artigo de Periódico |
Título : | Cyclophosphamide in the treatment of focal segmental glomerulosclerosis |
Otros títulos : | Brazilian Journal of Medical and Biological Research |
Autor : | Martinelli, Reinaldo Pessôa Pereira, Luiz José Silva, Oriana Maria Mattos e Okumura, Alice Setsuko Rocha, Heonir de Jesus Pereira da |
metadata.dc.creator: | Martinelli, Reinaldo Pessôa Pereira, Luiz José Silva, Oriana Maria Mattos e Okumura, Alice Setsuko Rocha, Heonir de Jesus Pereira da |
Resumen : | Prednisone is the initial treatment of primary focal segmental glomerulosclerosis. However, when immunosuppressive agents in combination with steroids are used in the treatment of prednisone-dependent and prednisone-resistant patients the remission rate is variable. We report a long-term trial using cyclophosphamide (2.0 to 3.0 mg/kg body weight for 12 weeks) in combination with prednisone (1.0 to 2.0 mg/kg body weight), as compared with prednisone alone for the treatment of prednisone-resistant and frequently relapsing nephrotic syndrome and focal segmental glomerulosclerosis. Fifty-four patients (34 males and 20 females) with a diagnosis of idiopathic nephrotic syndrome and focal segmental glomerulosclerosis, followed-up for an average of 86.1 ± 82.4 months, were evaluated. Complete remission occurred in 20.4% and partial remission in 14.8% of the patients treated with steroids and in 26.7 and 20.0% of the patients treated with cyclophosphamide + prednisone, respectively. Of the 24 prednisoneresistant patients treated with steroids in combination with cyclophosphamide, 33.3% obtained a complete/partial response. At the time of final evaluation, 25% of the patients treated with prednisone and 10.0% of those treated with prednisone in combination with cyclophosphamide had reached end-stage renal disease. Persistent nephrotic syndrome and progressive renal insufficiency were more frequently observed among the patients treated with prednisone alone (50.0 vs 33.3% and 33.3 vs 16.7%, respectively). The treatments were well tolerated and no patient experienced adverse reactions requiring discontinuation of medications. Although open-label and non-randomized, the present trial showed that cyclophosphamide is a reasonable choice for the treatment of primary focal segmental glomerulosclerosis and prednisone-resistant nephrotic syndrome. |
Palabras clave : | Prednisone Nephrotic syndrome Cyclophosphamide Primary glomerular disease Focal segmental glomerulosclerosis |
URI : | http://www.repositorio.ufba.br/ri/handle/ri/4801 |
Fecha de publicación : | 2004 |
Aparece en las colecciones: | Artigo Publicado em Periódico (Faculdade de Medicina) |
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