What is The Best Choice in Steroid-Dependent Nephrotic Syndrome: Mycophenolate Mofetil Plus Dexamethasone or Cyclosporine A

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dc.authorscopusid57281213900
dc.authorscopusid7005075504
dc.authorscopusid57202990242
dc.contributor.authorTuncay, Secil
dc.contributor.authorMir, Sevgi
dc.contributor.authorHakverdi, Gulden
dc.date.accessioned2023-01-12T20:16:16Z
dc.date.available2023-01-12T20:16:16Z
dc.date.issued2021
dc.departmentN/A/Departmenten_US
dc.description.abstractThe use of mycophenolatemofetil (MMF) in the treatment of steroid-dependent nephrotic syndrome (SDNS) is beneficial in decreasing the relapse rate and/or steroid dose. The effectiveness and long-term results of MMF/dexamethasone (DEX) in the treatment of SDNS are not well known. In this study, we aimed to determine the efficiency, safety, and long-term results of MMF/DEX in patients with SDNS in comparison with cyclosporine A (CsA) in a retrospective single-center trial. Between January 2009 and December 2015, 54 SDNS patients were treated with either MMF/DEX (n = 29) or CsA (n = 25). Relapse rates, relapse-free time, cumulative exposure to corticosteroids, proteinuria, and estimated glomerular filtration rate (eGFR) were retrospectively evaluated at 0, 3, 6, 12, 24, and 36 months after the initiation of treatment. The mean cumulative exposure to corticosteroids for the MMF/DEX and CsA groups was 72.40 +/- 71.85 mg/kg/year and 122.31 +/- 74.35 mg/kg/year, respectively. There was a significant decrease in the cumulative exposure to corticosteroids in the MMF/DEX group (Z = 3.869; P < 0.001). While the mean annual relapse for the MMF/DEX group was 1.07 +/- 0.25, it was 1.70 +/- 1.01 in the CsA group, and this difference was statistically significant (Z = 1.968; P = 0.049). Relapse-free time for the 1st, 2nd, and 3rd years compared between the MMF/DEX and CsA groups was 9.57 +/- 2.58 versus 6.38 +/- 2.43, 10.27 +/- 1.98 versus 8.28 +/- 2.28, and 9.67 +/- 2.06 versus 6.52 +/- 3.04, respectively. The difference was significantly higher in favor of MMF/DEX (between-subject effects F = 48.352; P < 0.001). Both eGFR and proteinuria significantly changed over time. However, there was no significant difference between the groups until the later time points of the follow-up. The difference became evident only at the 2nd-and 3rd-year measurements. MMF/DEX seems superior to CsA in preventing relapses and reducing cumulative exposure to cortico-steroids. Thus, it may be considered a treatment option in children with SDNS.en_US
dc.identifier.doi10.4103/1319-2442.338275
dc.identifier.endpage1027en_US
dc.identifier.issn1319-2442
dc.identifier.issn2320-3838
dc.identifier.issue4en_US
dc.identifier.pmid35229801en_US
dc.identifier.scopus2-s2.0-85125681859en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage1019en_US
dc.identifier.urihttps://doi.org/10.4103/1319-2442.338275
dc.identifier.urihttps://hdl.handle.net/11454/78683
dc.identifier.volume32en_US
dc.identifier.wosWOS:000795907600016en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherWolters Kluwer Medknow Publicationsen_US
dc.relation.ispartofSaudi Journal of Kidney Diseases and Transplantationen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectChildrenen_US
dc.subjectRemissionen_US
dc.subjectAgentsen_US
dc.titleWhat is The Best Choice in Steroid-Dependent Nephrotic Syndrome: Mycophenolate Mofetil Plus Dexamethasone or Cyclosporine Aen_US
dc.typeArticleen_US

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