Effects of cyclosporin a therapy combined with steroids and angiotensin converting enzyme inhibitors on childhood IgA nephropathy

Jaeil Shin, Beom Jin Lim, Pyung Kil Kim, Jae Seung Lee, Hyeon Joo Jeong, Ji Hong Kim

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Abstract

To evaluate the effects of cyclosporin A (CyA) on clinical outcome and pathologic changes in children with IgA nephropathy (IgAN), we retrospectively evaluated 14 children (mean age 8.9±2.9 yr; eight males, six females) who were treated with CyA and steroids. The starting dose of CyA was 5 mg/kg per day, and the drug level was maintained at 100-200 ng/mL. The mean CyA level was 183.8±48.3 ng/mL (range 120.7-276.0 ng/mL) and the mean duration of CyA therapy was 10.9±1.9 months (range 8-12 months). After CyA therapy the mean 24 hr urinary protein excretion declined from 107.1±35.1 mg/m 2 /hr to 7.4±2.4 mg/m 2 /hr (P<0.001) and serum albumin increased from 3.3±0.6 g/dL to 4.3±0.3 g/dL (P<0.001). At a follow-up biopsy the histological grade of IgAN was improved in seven (50%) of the 14 patients, remained the same in three (21%), and was aggravated in four (29%). Serum creatinine, creatinine clearance, and blood pressure did not differ before and after CyA therapy. Two patients (14%) showed CyA-induced nephrotoxicity at the second biopsy. Our findings indicate that CyA therapy may be effective in reducing proteinuria and regressing renal pathology in a subset of children with IgAN.

Original languageEnglish
Pages (from-to)723-727
Number of pages5
JournalJournal of Korean medical science
Volume25
Issue number5
DOIs
Publication statusPublished - 2010 May 1

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Angiotensin-Converting Enzyme Inhibitors
Immunoglobulin A
Cyclosporine
Steroids
Therapeutics
Creatinine
Biopsy
Proteinuria
Serum Albumin
Pathology
Blood Pressure
Kidney
Serum
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Shin, Jaeil ; Lim, Beom Jin ; Kim, Pyung Kil ; Lee, Jae Seung ; Jeong, Hyeon Joo ; Kim, Ji Hong. / Effects of cyclosporin a therapy combined with steroids and angiotensin converting enzyme inhibitors on childhood IgA nephropathy. In: Journal of Korean medical science. 2010 ; Vol. 25, No. 5. pp. 723-727.
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Effects of cyclosporin a therapy combined with steroids and angiotensin converting enzyme inhibitors on childhood IgA nephropathy. / Shin, Jaeil; Lim, Beom Jin; Kim, Pyung Kil; Lee, Jae Seung; Jeong, Hyeon Joo; Kim, Ji Hong.

In: Journal of Korean medical science, Vol. 25, No. 5, 01.05.2010, p. 723-727.

Research output: Contribution to journalArticle

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