Update on the treatment of steroid-sensitive nephrotic syndrome.
Calcineurin inhibitor
Cyclophosphamide
Cyclosporine A
Mycophenolate mofetil
Prednisone
Relapse
Rituximab
Tacrolimus
Journal
Pediatric nephrology (Berlin, Germany)
ISSN: 1432-198X
Titre abrégé: Pediatr Nephrol
Pays: Germany
ID NLM: 8708728
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
received:
07
12
2020
accepted:
02
02
2021
revised:
13
01
2021
pubmed:
6
3
2021
medline:
16
4
2022
entrez:
5
3
2021
Statut:
ppublish
Résumé
Steroid-sensitive nephrotic syndrome (SSNS) is a rare condition that develops primarily in preadolescent children after the age of 1 year. Since the 1950s, oral corticosteroids have been the mainstay of treatment of all children presenting with nephrotic syndrome, with most patients responding within 4 weeks to an oral course of prednisone (PDN). However, corticosteroids have important side effects and 60-80 % of patients relapse, developing frequently relapsing or steroid-dependent forms. For these reasons, many patients require second-line steroid-sparing immunosuppressive medications that have considerably improved relapse-free survival, while avoiding many PDN-related toxicities. Since most patients will eventually heal from their disease with a normal kidney function, the morbidity of SSNS is primarily related to side effects of drugs that are used to maintain prolonged remission. Therefore, treatment is essentially based on balancing the use of different drugs to achieve permanent remission with the lowest cumulative number of side effects. Treatment choice is based on the severity of SSNS, on patient age, and on drug tolerability. This review provides an update of currently available therapeutic strategies for SSNS.
Identifiants
pubmed: 33665752
doi: 10.1007/s00467-021-04983-3
pii: 10.1007/s00467-021-04983-3
doi:
Substances chimiques
Glucocorticoids
0
Immunosuppressive Agents
0
Cyclophosphamide
8N3DW7272P
Prednisone
VB0R961HZT
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
303-314Informations de copyright
© 2021. IPNA.
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