Introduction: Cyclosporine A is effective in treating steroid-dependent (SD) and steroid-resistant nephrotic syndrome (SRNS), despite its potential chronic nephrotoxicity. This study reports the results of a CsA (cyclosporine microemulsion, Sigma Pharma / Nature''s Plus, Brazil) treatment of 33 children with idiopathic nephrotic syndrome (INS), 17 of which were SRNS, and 16 showed signs of steroid toxicity. The histological diagnosis leading to the INS showed minimal changes in the disease (MCD) on 21 children, focal segmental glomerulosclerosis (FSGS) on 11 patients and membranous nephropathy (MN) on one. Only those children whose histological analyses showed a maximum of 30% of interstitial fibrosis, with normal renal and liver function, were included in the group. Method: CsA was administered at a dose of 5 mg/kg twice a day, in combination with alternateday prednisone. The dose was adjusted to maintain moderate levels between 50 and 150 ng/ml, as measured on whole blood by monoclonal radioimunoassay (RIA), for a period of 3 to 12 months. Results: In SRNS, CsA therapy in association with prednisone induced complete remission in 53% of the patients (9 children), incomplete or partial remission in 30% of the patients (5 children), and 29.4% of the patients(5) were only maintained on CsA. CsA therapy in association with prednisone induced complete remission in 100% of the patients (16 children) and, 81.2% of the patients (13 children), were only maintained on CsA in SD cases. Only one patient developed CsA nephrotoxicity. Conclusion: The association of alternate-day prednisone was highly effective in inducing complete remission in patients with SRNS and in tapering off the corticoids among those with signs of steroid toxicity.
Keywords: Steroid-dependent (SDNS). Steroid-resistant nephrotic syndrome (SRNS). Cyclosporine. Pediatric.;