Predictive factors for ciclosporin-associated nephrotoxicity in children with minimal change nephrotic syndrome

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

Research output: Contribution to journalArticle

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Abstract

Aims: To identify the predictive factors for ciclosporin A (CyA)-associated nephrotoxicity (CAN) in children with minimal change nephrotic syndrome (MCNS). Methods: The clinical and laboratory findings of 58 children (median age 3.2 years, range 1.1-13.1 years, male:female 48:10) with MCNS who were treated with CyA from 1992 to 2002 were analysed retrospectively. Forty-eight (83%) of them were steroid dependent and 10 (17%) were steroid resistant. The starting dose of CyA was 5 mg/kg per day, and the desired drug level was kept at 100-200 ng/ml. Serial renal biopsies were performed before and after CyA therapy. Results: Twenty-two patients (38%) had CAN (group I) and 36 (62%) did not (group II). There were no differences in the age at onset, sex, initial response to steroids, duration of CyA therapy and relapse rates. However, the median CyA trough levels were significantly higher in group I than in group II (218.0±15.2 vs 171.8±6.7 ng/ml, p=0.01). Changes in creatinine clearance were more decreased in group I than in group II (-39.4±8.2 vs 2.7±4.3 ml/min per 1.73 m 2, p<0.0001). Multiple logistic regression analysis also revealed the median CyA trough level was an independent risk factor for the development of CAN (OR 1.025, 95% CI 1.007 to 1.044, p=0.007). Conclusions: The median CyA trough level was an independent and significant risk factor for the development of CAN in children with MCNS receiving moderate-dose CyA.

Original languageEnglish
Pages (from-to)516-519
Number of pages4
JournalJournal of Clinical Pathology
Volume64
Issue number6
DOIs
Publication statusPublished - 2011 Jun 1

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Lipoid Nephrosis
Cyclosporine
Steroids
Age of Onset
Creatinine
Logistic Models
Regression Analysis
Kidney
Biopsy
Recurrence
Therapeutics
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

Cite this

Ji, Hong Kim ; Se, Jin Park ; So, Jin Yoon ; Beom, Jin Lim ; Hyeon, Joo Jeong ; Jae, Seung Lee ; Pyung, Kil Kim ; Shin, Jaeil. / Predictive factors for ciclosporin-associated nephrotoxicity in children with minimal change nephrotic syndrome. In: Journal of Clinical Pathology. 2011 ; Vol. 64, No. 6. pp. 516-519.
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abstract = "Aims: To identify the predictive factors for ciclosporin A (CyA)-associated nephrotoxicity (CAN) in children with minimal change nephrotic syndrome (MCNS). Methods: The clinical and laboratory findings of 58 children (median age 3.2 years, range 1.1-13.1 years, male:female 48:10) with MCNS who were treated with CyA from 1992 to 2002 were analysed retrospectively. Forty-eight (83{\%}) of them were steroid dependent and 10 (17{\%}) were steroid resistant. The starting dose of CyA was 5 mg/kg per day, and the desired drug level was kept at 100-200 ng/ml. Serial renal biopsies were performed before and after CyA therapy. Results: Twenty-two patients (38{\%}) had CAN (group I) and 36 (62{\%}) did not (group II). There were no differences in the age at onset, sex, initial response to steroids, duration of CyA therapy and relapse rates. However, the median CyA trough levels were significantly higher in group I than in group II (218.0±15.2 vs 171.8±6.7 ng/ml, p=0.01). Changes in creatinine clearance were more decreased in group I than in group II (-39.4±8.2 vs 2.7±4.3 ml/min per 1.73 m 2, p<0.0001). Multiple logistic regression analysis also revealed the median CyA trough level was an independent risk factor for the development of CAN (OR 1.025, 95{\%} CI 1.007 to 1.044, p=0.007). Conclusions: The median CyA trough level was an independent and significant risk factor for the development of CAN in children with MCNS receiving moderate-dose CyA.",
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Predictive factors for ciclosporin-associated nephrotoxicity in children with minimal change nephrotic syndrome. / Ji, Hong Kim; Se, Jin Park; So, Jin Yoon; Beom, Jin Lim; Hyeon, Joo Jeong; Jae, Seung Lee; Pyung, Kil Kim; Shin, Jaeil.

In: Journal of Clinical Pathology, Vol. 64, No. 6, 01.06.2011, p. 516-519.

Research output: Contribution to journalArticle

TY - JOUR

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AU - Ji, Hong Kim

AU - Se, Jin Park

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AU - Hyeon, Joo Jeong

AU - Jae, Seung Lee

AU - Pyung, Kil Kim

AU - Shin, Jaeil

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N2 - Aims: To identify the predictive factors for ciclosporin A (CyA)-associated nephrotoxicity (CAN) in children with minimal change nephrotic syndrome (MCNS). Methods: The clinical and laboratory findings of 58 children (median age 3.2 years, range 1.1-13.1 years, male:female 48:10) with MCNS who were treated with CyA from 1992 to 2002 were analysed retrospectively. Forty-eight (83%) of them were steroid dependent and 10 (17%) were steroid resistant. The starting dose of CyA was 5 mg/kg per day, and the desired drug level was kept at 100-200 ng/ml. Serial renal biopsies were performed before and after CyA therapy. Results: Twenty-two patients (38%) had CAN (group I) and 36 (62%) did not (group II). There were no differences in the age at onset, sex, initial response to steroids, duration of CyA therapy and relapse rates. However, the median CyA trough levels were significantly higher in group I than in group II (218.0±15.2 vs 171.8±6.7 ng/ml, p=0.01). Changes in creatinine clearance were more decreased in group I than in group II (-39.4±8.2 vs 2.7±4.3 ml/min per 1.73 m 2, p<0.0001). Multiple logistic regression analysis also revealed the median CyA trough level was an independent risk factor for the development of CAN (OR 1.025, 95% CI 1.007 to 1.044, p=0.007). Conclusions: The median CyA trough level was an independent and significant risk factor for the development of CAN in children with MCNS receiving moderate-dose CyA.

AB - Aims: To identify the predictive factors for ciclosporin A (CyA)-associated nephrotoxicity (CAN) in children with minimal change nephrotic syndrome (MCNS). Methods: The clinical and laboratory findings of 58 children (median age 3.2 years, range 1.1-13.1 years, male:female 48:10) with MCNS who were treated with CyA from 1992 to 2002 were analysed retrospectively. Forty-eight (83%) of them were steroid dependent and 10 (17%) were steroid resistant. The starting dose of CyA was 5 mg/kg per day, and the desired drug level was kept at 100-200 ng/ml. Serial renal biopsies were performed before and after CyA therapy. Results: Twenty-two patients (38%) had CAN (group I) and 36 (62%) did not (group II). There were no differences in the age at onset, sex, initial response to steroids, duration of CyA therapy and relapse rates. However, the median CyA trough levels were significantly higher in group I than in group II (218.0±15.2 vs 171.8±6.7 ng/ml, p=0.01). Changes in creatinine clearance were more decreased in group I than in group II (-39.4±8.2 vs 2.7±4.3 ml/min per 1.73 m 2, p<0.0001). Multiple logistic regression analysis also revealed the median CyA trough level was an independent risk factor for the development of CAN (OR 1.025, 95% CI 1.007 to 1.044, p=0.007). Conclusions: The median CyA trough level was an independent and significant risk factor for the development of CAN in children with MCNS receiving moderate-dose CyA.

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