PMCID: PMC3562866 DOI: 10.2215/CJN.08330812
BACKGROUND AND OBJECTIVES: In the FSGS Clinical Trial, 22 cyclosporine-treated and 20 mycophenolate/dexamethasone-treated patients experienced a complete or partial remission after 26 weeks, completed 52 weeks of treatment, and were studied through 78 weeks. Herein, changes in the urine protein/creatinine ratio (UP/C) and estimated GFR (eGFR) throughout the entire study period are defined.
DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: The FSGS Clinical Trial, which was conducted from November 2004 to January 2010, enrolled patients aged 2-40 years, with eGFR ≥40 ml/min per 1.73 m(2) and UP/C >1 mg/mg after ≥4 weeks of corticosteroid therapy. Both groups received lisinopril or losartan throughout the study. UP/C and eGFR were measured at 0, 26, 52, and 78 weeks.
RESULTS: The median UP/C in the cyclosporine- and mycophenolate/dexamethasone-responsive patients fell by 89.8% and 82.7% at 52 weeks; the fall was largely sustained at 78 weeks (74.7% and 80.3%, respectively). The mean eGFR fell by 19.4% in the cyclosporine group and rose by 7.0% in the mycophenolate mofetil/dexamethasone group at 52 weeks, but subsequently rose by 16.4% and fell by 2.6%, respectively, in the two groups from 52 to 78 weeks.
CONCLUSIONS: In this subset of responding FSGS patients, the improvement in UP/C after cyclosporine or mycophenolate/dexamethasone treatment was largely sustained for 6 months after therapy. Reduction in eGFR in the cyclosporine group was improved 6 months after cyclosporine was stopped although the levels were lower than baseline in seven patients who entered the study with decreased eGFR.
Clin J Am Soc Nephrol
Adolescent; Adult; Child; Child, Preschool; Cyclosporine; Dexamethasone; Drug Therapy, Combination; Female; Glomerulosclerosis, Focal Segmental; Humans; Immunosuppression; Immunosuppressive Agents; Kidney Function Tests; Male; Mycophenolic Acid; Prospective Studies; Proteinuria; Young Adult
Hogg, Ronald J.; Friedman, Aaron; Greene, Tom; Radeva, Milena; Budisavljevic, Milos N.; Gassman, Jennifer; Gipson, Debbie S.; Jefferson, J Ashley; John, Eunice G.; Kaskel, Frederick J.; Moudgil, Asha; Moxey-Mims, Marva; Ortiz, Luis A.; Schelling, Jeffrey R.; Schnaper, William; Srivastava, Tarak; Trachtman, Howard; Vehaskari, V Matti; Wong, Craig; Woronieki, Robert P.; Van Why, Scott K.; and Zolotnitskaya, Anna, "Renal function and proteinuria after successful immunosuppressive therapies in patients with FSGS." (2013). Manuscripts, Articles, Book Chapters and Other Papers. 1192.