Pavlović S, Djukanović Lj, Sindjić M, Stojković D, Banković-Calić N, Velimirović D
Institute of Urology and Nephrology, Clinical Centre of Serbia, Belgrade.
Srp Arh Celok Lek. 1996;124 Suppl 1:51-3.
Cyclosporin A (CyA) was administered at the Clinic of Nephrology, CCS, in treatment of 8 patients with steroid-resistant nephrotic syndrome (NS) caused by focal segmental glomerulosclerosis (FSG), Cyclophosphamide (CP) treatment was attempted in 6 of these cases, but without success. Prior to the onset of CyA therapy, CP treatment was interrupted, and the dose of prednisone was reduced to 0.4 mg/kg/48 h. CyA was applied in the initial dose of 5 mg/kg/bw/24h, and then adjusted so that CyA blood level was 80-120 ng/ml. Although CyA treatment caused proteinuric decrease in most of the patients (from 12.1 g/24 h to 8.2 g/24 h), complete NS remission was achieved in only one patient, the same as the incomplete one. The female patient with a positive response to CyA treatment behaved as "CyA-dependent" and each discontinuation of CyA therapy soon led to recurrent NS. Insignificant CyA effect on NS or renal function was registered in 4 patients, and the therapy was interrupted in two cases due to renal function impairment. Apart from nephrotoxicity, other CyA side effects were absent.
环孢素A（CyA）在CCS肾脏病诊所用于治疗8例由局灶节段性肾小球硬化（FSG）引起的激素抵抗性肾病综合征（NS）患者，其中6例尝试使用环磷酰胺（CP）治疗，但未成功。在开始使用CyA治疗之前，中断CP治疗，并将泼尼松剂量减至0.4mg/kg/48h。CyA初始剂量为5mg/kg/体重/24h，然后进行调整以使CyA血药浓度为80 - 120ng/ml。尽管CyA治疗使大多数患者蛋白尿减少（从12.1g/24h降至8.2g/24h），但仅1例患者实现了NS完全缓解，不完全缓解的情况相同。对CyA治疗有阳性反应的女性患者表现为“CyA依赖”，每次中断CyA治疗都会很快导致NS复发。4例患者中CyA对NS或肾功能的影响不显著，2例因肾功能损害而中断治疗。除肾毒性外，未出现其他CyA副作用。
