Literature DB >> 23143503

Renal function and proteinuria after successful immunosuppressive therapies in patients with FSGS.

Ronald J Hogg1, Aaron Friedman, Tom Greene, Milena Radeva, Milos N Budisavljevic, Jennifer Gassman, Debbie S Gipson, J Ashley Jefferson, Eunice G John, Frederick J Kaskel, Asha Moudgil, Marva Moxey-Mims, Luis A Ortiz, Jeffrey R Schelling, William Schnaper, Tarak Srivastava, Howard Trachtman, V Matti Vehaskari, Craig Wong, Robert P Woronieki, Scott K Van Why, Anna Zolotnitskaya.   

Abstract

BACKGROUND AND OBJECTIVES: In the FSGS Clinical Trial, 22 cyclosporine-treated and 20 mycophenolate/dexamethasone-treated patients experienced a complete or partial remission after 26 weeks, completed 52 weeks of treatment, and were studied through 78 weeks. Herein, changes in the urine protein/creatinine ratio (UP/C) and estimated GFR (eGFR) throughout the entire study period are defined. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: The FSGS Clinical Trial, which was conducted from November 2004 to January 2010, enrolled patients aged 2-40 years, with eGFR ≥40 ml/min per 1.73 m(2) and UP/C >1 mg/mg after ≥4 weeks of corticosteroid therapy. Both groups received lisinopril or losartan throughout the study. UP/C and eGFR were measured at 0, 26, 52, and 78 weeks.
RESULTS: The median UP/C in the cyclosporine- and mycophenolate/dexamethasone-responsive patients fell by 89.8% and 82.7% at 52 weeks; the fall was largely sustained at 78 weeks (74.7% and 80.3%, respectively). The mean eGFR fell by 19.4% in the cyclosporine group and rose by 7.0% in the mycophenolate mofetil/dexamethasone group at 52 weeks, but subsequently rose by 16.4% and fell by 2.6%, respectively, in the two groups from 52 to 78 weeks.
CONCLUSIONS: In this subset of responding FSGS patients, the improvement in UP/C after cyclosporine or mycophenolate/dexamethasone treatment was largely sustained for 6 months after therapy. Reduction in eGFR in the cyclosporine group was improved 6 months after cyclosporine was stopped although the levels were lower than baseline in seven patients who entered the study with decreased eGFR.

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Year:  2012        PMID: 23143503      PMCID: PMC3562866          DOI: 10.2215/CJN.08330812

Source DB:  PubMed          Journal:  Clin J Am Soc Nephrol        ISSN: 1555-9041            Impact factor:   8.237


  18 in total

1.  A randomized trial of cyclosporine in patients with steroid-resistant focal segmental glomerulosclerosis. North America Nephrotic Syndrome Study Group.

Authors:  D C Cattran; G B Appel; L A Hebert; L G Hunsicker; M A Pohl; W E Hoy; D R Maxwell; C L Kunis
Journal:  Kidney Int       Date:  1999-12       Impact factor: 10.612

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Journal:  Nephron       Date:  1976       Impact factor: 2.847

3.  A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine.

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Journal:  Pediatrics       Date:  1976-08       Impact factor: 7.124

4.  Renin-angiotensin-aldosterone system inhibitors in pediatric focal segmental glomerulosclerosis.

Authors:  Shreya Kangovi; Meredith Edwards; Stephen Woloszynek; Nandita Mitra; Harold Feldman; Bernard S Kaplan; Kevin E Meyers
Journal:  Pediatr Nephrol       Date:  2011-11-25       Impact factor: 3.714

Review 5.  Management of focal segmental glomerulosclerosis: evidence-based recommendations.

Authors:  E Burgess
Journal:  Kidney Int Suppl       Date:  1999-06       Impact factor: 10.545

6.  Mycophenolate mofetil in the treatment of focal segmental glomerulosclerosis.

Authors:  D C Cattran; M M Wang; G Appel; A Matalon; W Briggs
Journal:  Clin Nephrol       Date:  2004-12       Impact factor: 0.975

7.  A randomized double-blind placebo-controlled trial of cyclosporine in steroid-resistant idiopathic focal segmental glomerulosclerosis in children.

Authors:  K V Lieberman; A Tejani
Journal:  J Am Soc Nephrol       Date:  1996-01       Impact factor: 10.121

8.  Focal segmental glomerular sclerosis in adults: presentation, course, and response to treatment.

Authors:  J J Rydel; S M Korbet; R Z Borok; M M Schwartz
Journal:  Am J Kidney Dis       Date:  1995-04       Impact factor: 8.860

9.  A randomized trial of cyclosporine in steroid-resistant idiopathic nephrotic syndrome.

Authors:  C Ponticelli; G Rizzoni; A Edefonti; P Altieri; E Rivolta; S Rinaldi; L Ghio; E Lusvarghi; R Gusmano; F Locatelli
Journal:  Kidney Int       Date:  1993-06       Impact factor: 10.612

10.  Cyclosporine A and chlorambucil in the treatment of idiopathic focal segmental glomerulosclerosis.

Authors:  Peter Heering; Norbert Braun; Reinhard Müllejans; Katrin Ivens; Ingeborg Zäuner; Reinhard Fünfstück; Frieder Keller; Bernhard K Krämer; Peter Schollmeyer; Teut Risler; Bernd Grabensee
Journal:  Am J Kidney Dis       Date:  2004-01       Impact factor: 8.860

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  9 in total

1.  Response to cyclosporine in steroid-resistant nephrotic syndrome: discontinuation is possible.

Authors:  Ilka Klaassen; Bünyamin Özgören; Carolin E Sadowski; Kristina Möller; Michael van Husen; Anja Lehnhardt; Kirsten Timmermann; Folke Freudenberg; Udo Helmchen; Jun Oh; Markus J Kemper
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Review 2.  Steroid-resistant nephrotic syndrome: a persistent challenge for pediatric nephrology.

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Journal:  Pediatr Nephrol       Date:  2016-10-26       Impact factor: 3.714

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Authors:  Elisabeth M Hodson; Sophia C Wong; Narelle S Willis; Jonathan C Craig
Journal:  Cochrane Database Syst Rev       Date:  2016-10-11

Review 4.  Interventions for focal segmental glomerulosclerosis in adults.

Authors:  Elisabeth M Hodson; Aditi Sinha; Tess E Cooper
Journal:  Cochrane Database Syst Rev       Date:  2022-02-28

5.  Podocyte repopulation by renal progenitor cells following glucocorticoids treatment in experimental FSGS.

Authors:  Jiong Zhang; Jeffrey W Pippin; Ronald D Krofft; Shokichi Naito; Zhi-Hong Liu; Stuart J Shankland
Journal:  Am J Physiol Renal Physiol       Date:  2013-03-13

6.  Serum glomerular albumin permeability activity: association with rapid progression to end-stage renal disease in focal segmental glomerulosclerosis.

Authors:  Sudhindra Pudur; Tarak Srivastava; Mukut Sharma; Ram Sharma; Sergey Tarima; Hongying Dai; Ellen T McCarthy; Virginia J Savin
Journal:  Springerplus       Date:  2016-04-11

7.  Study Design of the Phase 3 Sparsentan Versus Irbesartan (DUPLEX) Study in Patients With Focal Segmental Glomerulosclerosis.

Authors:  Radko Komers; Ulysses Diva; Jula K Inrig; Andrea Loewen; Howard Trachtman; William E Rote
Journal:  Kidney Int Rep       Date:  2020-01-08

8.  Efficacy and Safety of ACE Inhibitor and Angiotensin Receptor Blocker Therapies in Primary Focal Segmental Glomerulosclerosis Treatment: A Systematic Review and Meta-Analysis.

Authors:  Kirk N Campbell; Natali Pennese; Andrea Zaffalon; Barbara Magalhaes; Marina Faiella; Dawn J Caster; Jai Radhakrishnan; Vladimir Tesar; Howard Trachtman
Journal:  Kidney Med       Date:  2022-03-24

9.  Efficacy and Safety of Immunosuppressive Therapy in Primary Focal Segmental Glomerulosclerosis: A Systematic Review and Meta-analysis.

Authors:  Dawn J Caster; Barbara Magalhaes; Natali Pennese; Andrea Zaffalon; Marina Faiella; Kirk N Campbell; Jai Radhakrishnan; Vladmir Tesar; Howard Trachtman
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