Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: Steroid resistant nephrotic syndrome is a progressive non uncommen disorder that can lead to ESRD in children with NS. We aimed to identify the percentage of CNIs responsive cases among childhood onset SRNS treated with CNIs, to study the indications, toxic spectrum, and optimum combined therapeutic modalities of CNIs use in SRNS, and to describe the outcome of SRNS cases treated with CNIs. Methods: This is a retrospective descriptive study included 50 patients with childhood onset SRNS on CNI therapy. History taking, physical examination, and review of medical recoreds as regard their laboratory data and therapeutic interventions were done. Results: Combination of CNI and steroid significantly achieved remission and steroid tapering (p=<0.001) in the study group. The mean dose of CsA was115.50±48.94 mg/m2 after 3 months of CsA therapy initiation which was significantly higher than that after 1 year therapy (88.93±68 mg/m2) (p=0.008). The mean CsA dose that achieved remission was 5.39±0.49 mg/kg. 24% of cases achieved complete remission, 12% became infrequent relapsers, 10% showed partial remission and 42% showed no response. CsA was used as the first line of therapy in 22 SRNS patients (36% showed complete response, 45% showed partial response and 18% showed no response). MMF and/or CPA were used in addition to CNI in 12 cases at different time period to reach to achieve remission. MMF and/or CPA were used in addition to CNI in 12 cases at different time period to reach to achieve remission

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