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Journals / Dicle Tıp Dergisi / 2011 / Cilt: 38 - Sayı: 3

Treatment approaches in children with steroid sensitive nephrotic syndrome

Steroide yanıtlı nefrotik sendromlu çocuklarda tedavi yaklaşımları

Süleyman KALMAN
Pages
361–367
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

It is therefore important that the benefits and risks of these agents are weighed before considering their use in the treatment of patients with NS.

📌 3 Key Takeaways

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Objective & Hypothesis:Pediatric nephrotic syndrome (NS) is a chronic glomerular disorder, and if untreated, is associated with increased risk of life-threatening infectious, thromboembolism, lipid abnormalities, and malnutrition.
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Key Findings & Data:Over 90% of cases in children with idiopathic NS and a majority of them will respond to steroid therapy.
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Conclusion & Impact:It is therefore important that the benefits and risks of these agents are weighed before considering their use in the treatment of patients with NS.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Pediatric nephrotic syndrome (NS) is a chronic glomerular disorder, and if untreated, is associated with increased risk of life-threatening infectious, thromboembolism, lipid abnormalities, and malnutrition. The aim of the management of NS in children is to induce and maintain complete remission with resolution of proteinuria and edema without encountering serious adverse effects of therapy. Over 90% of cases in children with idiopathic NS and a majority of them will respond to steroid therapy. However, a substantial number of patients relapse frequently and become steroid dependent. The occurrence of frequent relapses necessitates clear therapeutic strategies in order to maintain sustained remission and minimize steroid toxicity. Numerous therapeutic regimens have been proposed utilizing steroid sparing agents such as alkylating agents, principally, cyclophosphamide and chlorambucil, calcineurin inhibitors namely cyclosporin A and an immunomodulatory drug, levamisole, with variable success and associated side-effects. Recently, mycophenolate mofetil (MMF), tacrolimus, the anti-CD20 antibody, rituximab, have emerged as new therapeutic options for the management of steroid dependent NS in a few uncontrolled clinical trials. It is therefore important that the benefits and risks of these agents are weighed before considering their use in the treatment of patients with NS.

Özet

Çocukluk çağı nefrotik sendromu kronik bir glomerül hastalığıdır. Eğer tedavi edilmezse, yaşamı tehdit eden enfeksiyonlar, tromboembolizm, lipid anormallikleri ve malnutrisyon gibi komplikasyonları vardır. Tedavinin amacı proteinüriyi ve ödemi ciddi yan etkiler ortaya çıkmadan düzeltmektir. İdiopatik nefrotik sendromun (İNS) %90’dan fazlası steroid tedavisine yanıt verir. Bununla birlikte, önemli sayıda hasta sık relaps gösterir ve steroide bağımlı hale gelir. Sık relapsların ortaya çıkışı remisyon sağlayıcı ve steroid toksisitesini azaltıcı yeni tedavi stratejilerini gerektirir Steroid yan etkilerinden koruyucu tedavi rejimleri olarak alkilleyici ajanlar (siklofosfamid ve klorombusil), kalsinörin inhibitörleri (siklosporin A), immunomodulatör ajanlar (levamizol) önerilmiştir. Yakın zamanlarda, mikofenolat mofetil (MMF), tacrolimus, anti-CD20 antikoru olan rituximab steroid bağımlı nefrotik sendromda (SBNS) az sayıda kontrolsuz çalışma ile yeni tedavi seçenekleri olarak ortaya çıkmıştır. Bu nedenle nefrotik sendromlu çocuklarda bu ilaç tedavilerinin, kullanılmadan önce yarar ve risklerinin çok iyi değerlendirilmesinin önemi ortaya çıkmaktadır.

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Cite This Article

KALMAN, S. (2011). Treatment approaches in children with steroid sensitive nephrotic syndrome. Dicle Tıp Dergisi, Cilt: 38 - Sayı: 3, 361–367. https://ajindex.com/articles/349758

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