Abstract
Nephrotic syndrome secondary to FGS is usually unresponsive to steroids and progresses, in many cases, to end-stage renal disease. Alkylating agents, chlorambucil (CH), cyclophosphamide (CY), appear to decrease the frequency of relapses or to prolong remission in the minimal change nephrotic syndrome (MCNS), but their efficacy in the treatment of FGS is still debatable.
5 patients presented with nephrotic syndrome. Initially responsive to prednisone, 4 of 5 had multiple relapses, but at the time of treatment with alkylating agents, steroid resistance was present in each (1 to 3 months duration).
Percutaneous renal biopsy was done before therapy; each had FGS. Interstitial fibrosis and tubular atrophy were present in G.F. CH, 0.3 mg/k/day or CY, 1.5 mg/kg/day were started and prednisone 2 mg/kg/day was continued every second day. A complete remission was obtained in every patient and maintained as long as 21 m after cessation of the alkylating therapy.
Some patients with FGS thus appear to benefit from 8 w treatment with an alkylating agent.
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Lemire, J., De Chadarévian, JP. & Kaplan, B. 1516 TREATMENT OF FOCAL GLOMERULOSCLEROSIS (FGS) WITH ALKYLATING AGENTS. Pediatr Res 15 (Suppl 4), 696 (1981). https://doi.org/10.1203/00006450-198104001-01539
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DOI: https://doi.org/10.1203/00006450-198104001-01539