Abstract
Over the past 5 years there has been a revival of interest in the combined use of steroids and immunosuppressive agents in the child with the idiopathic nephrotic syndrome (INS) who is either SR or SD. The combined administration of steroids and cyclophdsphamide is usually effective in inducing an initial response in the majority. Little information is available on the cource of these patients after cyclophosphamide is discontinued.
Of 169 patients with INS, approximately 40 % were found to be either SR or SD. Thirty-five of these were evaluated and subjected to cmbined therapy. Eleven were SR and 24 were SD. Seventeen of the 35 are classifiedas having ‘lipid’ nephrosis,while 10 had proliferative and 8, membraneous glomerulonephritis. Eighteen SD patients had a complete initial response while 6 SR patients exhibited a similar response. An additional 3 SR patients had a partial response. Approximately 50 % of the patients who initially had a complete response and who have been followed for at least 6 months after discontinuing cyclophosphamide, have, however, had further exacerbations and their ultimate course does not appear to have been materially altered.
This study would suggest that 1. SR and SD are not infrequent; 2. clinical and pathologic studies may define groups of patients who are either steroid sensitive, SR or SD, but may be of little help with individual patients; 3. combined therapy will usually induce an initial complete response; 4. approximately one-half of patients so treated will ultimately revert to some degree of unresponsiveness. (SPR)
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Travis, L., Dodge, W. 43 Evaluation of Combined Therapy (Steroids and Cyclophosphamide) in the Steroid Resistant (SR) and Steroid Dependent (SD) Nephrotic Syndrome. Pediatr Res 1, 211 (1967). https://doi.org/10.1203/00006450-196705000-00050
Issue Date:
DOI: https://doi.org/10.1203/00006450-196705000-00050