Abstract | INTRODUTION: OBJECTIVE: The aim of this retrospective study is to evaluate the efficacy of immunosuppressive drugs (IS) and to identify risk factors for progression to ESRD in this population. METHODS: Clinical and biochemical variables at presentation, early or late steroid resistance, histological pattern and response to cyclosporine A (CsA) and cyclophosfamide (CP) were reviewed in 136 children with SRINS. The analyzed outcome was the progression to ESRD. Univariate as well as multivariate Cox-regression analysis were performed. RESULTS: Median age at onset was 5.54 years (0.67-17.22) and median follow up time was 6.1 years (0.25-30.83). Early steroid-resistance was observed in 114 patients and late resistance in 22. Resistance to CP and CsA was 62.9% and 35% respectively. At last follow-up 57 patients reached ESRD. The renal survival rate was 71.5%, 58.4%, 55.3%, 35.6% and 28.5% at 5, 10, 15, 20 and 25 years respectively. Univariate analysis demonstrated that older age at onset, early steroid-resistance, hematuria, hypertension, focal segmental glomerulosclerosis (FSGS), and resistance to IS were risk factors for ESRD. The Cox proportional-hazards regression identified CsAresistance and FSGS as the only predictors for ESRD. CONCLUSION: Our findings showed that CsA-resistance and FSGS were risk factors for ESRD.
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Authors | Alberto Zagury, Anne Louise de Oliveira, Jose Augusto Araujo Montalvão, Regina Helena Leite Novaes, Vinicius Martins de Sá, Carlos Augusto Pinheiro de Moraes, Marcelo de Sousa Tavares |
Journal | Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
(J Bras Nefrol)
2013 Jul-Sep
Vol. 35
Issue 3
Pg. 191-9
ISSN: 2175-8239 [Electronic] Brazil |
PMID | 24100738
(Publication Type: Journal Article)
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Chemical References |
- Immunosuppressive Agents
- Cyclosporine
- Cyclophosphamide
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Topics |
- Adolescent
- Child
- Child, Preschool
- Cohort Studies
- Cyclophosphamide
(therapeutic use)
- Cyclosporine
(therapeutic use)
- Disease Progression
- Female
- Follow-Up Studies
- Humans
- Immunosuppressive Agents
(therapeutic use)
- Infant
- Kidney Failure, Chronic
(etiology)
- Male
- Nephrotic Syndrome
(complications, congenital, drug therapy)
- Retrospective Studies
- Risk Factors
- Time Factors
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