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A Retrospective Study on the Effect of Cyclophosphamide in Children with Minmal Change Nephrotic Syndrome.

Journal of the Korean Pediatric Society 1987;30(2):158-174.
Published online February 28, 1987.
A Retrospective Study on the Effect of Cyclophosphamide in Children with Minmal Change Nephrotic Syndrome.
Il Soo Ha1, Kwang Wook Ko1, Yong Il Kim2
1Department of Pediatrics, College of Medicine, Seoul National University
2Department of Pathology, College of Medicine, Seoul National University
소아기의 미소병변 신증후군에 있어서의 Cyclophosphamide의 치료효과
하 일수1, 고 광 욱1, 김용일2
1서울대학교 의과대학 소아과학교실
2서울대학교 의과대학 병리학교실
Abstract
Thirty one children associated with biopsy-proven minimal change nephrotic syndrome with frequent relapse, were placed on cyclophosphamide, and its effect was analyzed. Cyclophosphamide was given with the dosage of 2.46±0.42 mg/kg/day for 58±7 days along with the alternate day corticosteroid. Sixty three percent of the patients showed complete remission and twenty seven percent of the patients resulted in partial remission after the treatment. Those who had focal tubular change or crescent on renal biopsy showed lower remission rate, and those who were subsequent nonresponder to steroid therapy showed lower complete remission rate. The mean response day after the treatment for the group with complete remission was 27th day of the administration of cyclophosphamide, and was earlier than that with partial remission. Forty eight percent and seventy two percent of the patients relapsed within one to two years after cyclophosphamide treatment respectively. With the cyclophosphamide treatment, the duration of remission became longer (p< 0.005), and the annual relapse rate decreased significantly (p< 0.005) than pretreatment period, while the mean steroid response day during relapses was not changed as a whole. The subsequent nonresponder to steroid therapy not only showed less complete remission rate but also shorter duration of remission than others, but their responsiveness to steroid was improved after cyclophosphamide treatment. No serious side effect of cyclophosphamide was observed during the treatment period. With the above results, we further confirmed that cyclophosphamide can be used effectively and safely for the patients with minimal change nephrotic syndrome who may have possible serious steroid toxicity.
Key Words: Minimal Change Nephrotic Syndrome, Cyclophosphamide frequent relapser


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