Patients with SRNS have persistent HC that may accelerate deterioration in kidney function and be a risk factor for premature cardiovascular morbidity. HMG CoA reductase inhibitors represent a novel option for the management of HC. We report our experience with L in 4 children with SRNS, the first of its kind in pediatrics.

Patients (3M:1F) ranged in age from 5-15 yr. FSGS was the underlying diagnosis in all cases. The serum creatinine concentration (Mean±SD) was 1.05±0.75 mg/dl and was elevated in 2/4 cases. Lipid profiles(total cholesterol [CHOL], HDL, and triglyceride [TG]) were obtained at the start and end of L therapy. Table

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L therapy resulted in a 34±16% decline in total CHOL (P<0.03) without consistently reducing TG levels. There was no hepatotoxicity; however, L was discontinued in patient #1 when CPK rose from 51 to 6390 U/L. All patients, except #2, were on cyclosporine. We conclude that L treatment of HC is as effective in patients with SRNS as in primary HC. However, surveillance is required to exclude an increased risk of myopathy in children, especially in those on cyclosporine.