[The treatment of children with idiopathic nephrotic syndrome using cyclosporin].

We report our experience with cyclosporine in 14 children with steroid dependent and 7 children with steroid resistant nephrotic syndrome. Cyclosporine was started at a dose of 6 mg/kg/day and was adjusted to maintain a blood level between 60 and 100 ng/ml. 15 patients went into remission with a combined treatment of cyclosporine and prednisone; 9 of these did not have a recurrence following discontinuation of prednisone. In 7 out of these 9 patients cyclosporine was also discontinued, this led in 5 of these 7 patients to a recurrence. Seven out of 14 patients with minimal change nephropathy remained in remission following discontinuation of prednisone and in 4 others the dose of steroid required to maintain remission decreased. In only I out of 4 patients with focal segmental glomerulosclerosis was a remission obtained while in two patients with mesangial proliferation the urine remained protein free during cyclosporine treatment. In 13 patients a repeat biopsy was performed after one year or longer of cyclosporine treatment. Histopathological abnormalities related to cyclosporine were found in 9 patients. In 4 of these severe nephrotoxicity required withdrawal of cyclosporine. Treatment with cyclosporine should be restricted to steroid dependent patients with severe steroid toxicity.