Inoue Makoto, Yumura Wako, Morishita Yoshiyuki, Ito Chiharu, Hamano Yoshiaki, Ando Yasuhiro, Muto Shigeaki, Kusano Eiji
Jichi Medical University, Department of Medicine, Division of Nephrology, Tochigi, Japan.
Clin Nephrol. 2013 Feb;79(2):101-6. doi: 10.5414/CN107518.
The long-term efficacy and safety of cyclosporine (CyA) in the treatment of adult minimal change nephrotic syndrome (MCNS) was examined.
The medical record of 15 patients diagnosed with MCNS by renal biopsy and treated with CyA for at least 2 years were reviewed.
The mean administration period of CyA was 78.3 months. The mean CyA dose for the induction period was 2.1 ± 0.9 mg/kg and 1.7 ± 1.0 mg/kg for the maintenance period. The mean dose of prednisolone used during the induction period was 20.3 mg and 2.7 mg during the maintenance. The frequency of MCNS relapse was decreased to 0.5 times/year in patients treated with CyA, compared to treatment without CyA (2.4 times/y). Two cases of mild liver damage and 3 cases of elevated blood pressure were observed during the administration of CyA. These adverse effects improved after reducing the CyA dose or treatment with an antihypertensive agent. A decrease in the estimated glomerular filtraion rate (eGFR) was not associated with long-term CyA use.
At our institution, patients who were treated for MCNS with CyA for at least 2 years experienced no deterioration in renal function.
研究环孢素(CyA)治疗成人微小病变肾病综合征(MCNS)的长期疗效和安全性。
回顾15例经肾活检确诊为MCNS并接受CyA治疗至少2年患者的病历。
CyA的平均给药期为78.3个月。诱导期CyA的平均剂量为2.1±0.9mg/kg,维持期为1.7±1.0mg/kg。诱导期使用泼尼松龙的平均剂量为20.3mg,维持期为2.7mg。与未使用CyA治疗的患者(2.4次/年)相比,接受CyA治疗的患者MCNS复发频率降至0.5次/年。在服用CyA期间观察到2例轻度肝损伤和3例血压升高。降低CyA剂量或用抗高血压药物治疗后,这些不良反应有所改善。估计肾小球滤过率(eGFR)的降低与长期使用CyA无关。
在我们机构,接受CyA治疗至少2年的MCNS患者肾功能未恶化。