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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Management of steroid-resistant focal segmental glomerulosclerosis in children using tacrolimus
American Journal of Nephrology, Volume 26, No. 6, Year 2007
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Description
Background: The use of tacrolimus in steroid-resistant (SR) focal segmental glomerulosclerosis (FSGS) has been reported in single and small series case reports. Aim: To determine the efficacy of tacrolimus in the management of SR FSGS in children. Study Design: This was a prospective study of 20 children with SR FSGS treated with tacrolimus (0.2-0.4 mg/kg/day in two divided doses over 12 h adjusted to a trough level between 7 and 15 ng/ml) for 12 months in combination with low-dose steroids. Other therapies included angiotensin-converting enzyme inhibitors, folic acid, multivitamins and lipid-lowering agents. Results: The mean age at study entry was 11.1 years (range 5.6-16.8). The mean duration of nephrotic syndrome before initiation of tacrolimus therapy was 4.7 years (range 2.1-7.6). At the end of the treatment period, 8 (40%) children were in complete remission, 9 (45%) were in partial remission, and 3 (15%) failed to respond. The average follow-up period following cessation of tacrolimus treatment was 27.5 months (range 13.7-43.7). At last hospital follow-up, 5 (25%) children were in complete remission, 10 (50%) in partial remission, and 2 (10%) in relapse. Three children died from dialysis-related complications following cessation of tacrolimus treatment. Adverse events included sepsis (2), nausea (2), diarrhea (2), anemia (4) and worsening of hypertension (4). Conclusion: Tacrolimus is a safe and effective treatment for SR FSGS. However, like cyclosporine, some children tend to relapse following cessation of treatment. Copyright © 2006 S. Karger AG.
Authors & Co-Authors
Bhimma, Rajendra
South Africa, Durban
The Nelson R. Mandela Medical School
Adhikari, Mirriam A.
South Africa, Durban
The Nelson R. Mandela Medical School
Asharam, Kareshma
South Africa, Durban
The Nelson R. Mandela Medical School
Connolly, Catherine Anne
South Africa, Durban
The Nelson R. Mandela Medical School
Statistics
Citations: 48
Authors: 4
Affiliations: 1
Identifiers
Doi:
10.1159/000097864
ISSN:
02508095
Research Areas
Health System And Policy
Maternal And Child Health
Noncommunicable Diseases
Study Design
Cohort Study