Cyclosporine versus cyclophosphamide in childhood nephrotic syndrome

Objective: to determine the response of cyclosporine versus cyclophosphamide in childhood nephrotic syndrome. place and duration: nephrology unit,national institute of child health,karachi,from april - september 2012. study design: prospective comparative study. methods: 158 patients aged 6 months to 15 years with either steroid resistant (sr) or steroid dependent nephrotic syndrome (sdns) were randomly assigned to receive either cyclosporine (cs –arm) or cyclophosphamide (cp-arm) for 3 months along with alternate day prednisolone. treatment response and side effects were monitored clinically and by laboratory tests (spot urine protein–creatinine ratio in both arms,serum creatinine in cs-arm and complete blood counts in cp-arm). outcome was defined after 12 weeks as complete remission (cr),partial remission and resistance. data including demographics,type of ns,treatment response and adverse effects were collected and analyzed on spss-16. results: there were 79 patients in each arm. mean age in both arms was almost identical (6.8±3.9 and 6.9±3.7 years). among 158,87(55%) were sd and 71(45%) were srns. majority (78.5%) in cs-arm achieved cr compared to 34.2% in cp- arm. this is highly significant (p value <0.001). partial remission was observed in 19% of cs –arm compared to 48% in cp-arm and 2.5% were resistant in cs – arm compared to 17.7% in cp –arm. hypertrichosis (5%),hypertension (3.7%),gum hyperplasia(3.7%),nephrotoxicity(2.5%) were observed in cs -arm,whereas bone marrow suppression (7.5%),alopecia and infections (2.5% each) were noted in cp- arm. conclusions: cyclosporine was more effective in inducing remission (78.5%) as compared to cyclophosphamide (34.2%) in childhood ns. © 2016,liaquat university of medical and health sciences. all rights reserved.