Treatment of steroid-resistant focal segmental glomerulosclerosis with pulse methylprednisolone and alkylating agents

Stanley A. Mendoza*, Vivian M. Reznik, William R. Griswold, Alan M. Krensky, Peter D. Yorgin, Bruce M. Tune

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

147 Scopus citations

Abstract

In children, steroid-resistant nephrotic syndrome due to focal segmental glomerulosclerosis (FSGS) is frequently a progressive condition resulting in end-stage renal disease. There have been no reports of effective treatment for this condition. For the past several years, the Pediatric Nephrology services at the University of California, San Diego and Stanford University Schools of Medicine have treated these patients with a protocol involving infusions of high doses of methylprednisolone, often in combination with oral alkylating agents. Twenty-three children have been treated in this manner with a follow-up of 46±5 months. Twelve of these children are in complete remission. Six have minimal to moderate proteinuria. Four children remain nephrotic. Each of these children has a normal glomerular filtration rate. One child developed chronic renal failure and subsequently died while on dialysis. These results appear significantly better than previous series of children with FSGS. A controlled, multi-center trial of this protocol has been proposed.

Original languageEnglish (US)
Pages (from-to)303-307
Number of pages5
JournalPediatric Nephrology
Volume4
Issue number4
DOIs
StatePublished - Jul 1 1990

Keywords

  • Alkylating agents
  • Chronic renal failure
  • Focal segmental glomerulosclerosis
  • Methylprednisolone
  • Nephrotic syndrome
  • Proteinuria

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

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