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Pilot trial of fk 506 in the management of steroid-resistant nephrotic syndrome

McCalley, J and Shapiro, R and Igdal, H and Tzakis, A and Starzl, TE and McCalley, J and Shapiro, R and Ellis, D and Tzakis, A and Starzl, TE and McCalley, J and Igdal, H and Starzl, TE (1993) Pilot trial of fk 506 in the management of steroid-resistant nephrotic syndrome. Nephrology Dialysis Transplantation, 8 (11). 1286 - 1290. ISSN 0931-0509

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Abstract

Seven patients with steroid-resistant nephrotic syndrome were treated with FK 506 monotherapy. Four patients were children with focal sclerosing glomerulonephritis (FSGS). Three of these had evldence for chronic progressive renal disease consisting of interstitial fibrosis and tubular atrophy on pretreatment renal biopsies. Two patients had also failed cyclosporin A (CsA), two cyclophosphamide, and one chlorambucil prior to treatment with FK 506. Three patients were adults wlth mesangial proliferative. membranoproliferative, and membranous glomerulonephritis. Three patterns of response were noted: (1) a reduction in proteinuria to normal levels, (2) partial response (50% reduction) or; (3) no improvement. All patients except one experienced at least a 50% reduction in protein excretion at some time during FK 506 therapy. Two of the children and one adult reduced protein excretion to essentially normal values. One patient had no sustained reduction In Droteln excretion and is considered to be a treatment fallure, although her protein excretion was approximately 50% of pretreatment values intermittently. The drug was generally well tolerated. The most common side-effect was nephrotoxlclty, whlch was reversible. These encouraging results suggest that FK 506 monotherapy may be effective in controlling the proteinuria of somc patlents with steroid-resistant nephrotic syndrome The use of this drug may extend our understanding of the role of T lymphocytes and cytokines in the pathogenesls of glomerulonephritis. Further study of this agent In a larger population of patlents is warranted. © 1993 European Dial ysis and Transplant Assoiation-European Renal Association.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
McCalley, J
Shapiro, R
Igdal, H
Tzakis, A
Starzl, TE
McCalley, J
Shapiro, R
Ellis, D
Tzakis, A
Starzl, TE
McCalley, J
Igdal, H
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1993
Date Type: Publication
Journal or Publication Title: Nephrology Dialysis Transplantation
Volume: 8
Number: 11
Page Range: 1286 - 1290
DOI or Unique Handle: 10.1093/oxfordjournals.ndt.a092351
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0931-0509
Other ID: uls-drl:31735062125855, Starzl CV No. 1644
Date Deposited: 08 Apr 2010 17:27
Last Modified: 13 Oct 2017 22:56
URI: http://d-scholarship.pitt.edu/id/eprint/5030

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