Tacrolimus in steroid-resistant and steroid-dependent nephrotic syndrome. Westhoff, T. H., Schmidt, S., Zidek, W., Beige, J., & van der Giet, M. Clinical nephrology, 65(6):393--400, June, 2006. abstract bibtex BACKGROUND: Steroid resistance and steroid dependence constitute a major problem in the treatment of minimal-change disease and focal segmental glomerulosclerosis (FSGS). Cyclophosphamide and cyclosporine are well-established alternative immunomodulating agents, whereas data on FK 506 (tacrolimus) are rare. METHODS: The present work provides data from 10 patients of an open, monocentric, non-randomized, prospective trial. Five patients with steroid-dependent minimal-change nephrotic syndrome, 1 patient with steroid-refractory minimal-change disease and 4 patients with steroid-refractory FSGS were started on tacrolimus at trough levels of 5 10 microg/l. In case of steroid-dependence, prednisolone was tapered off in presence oftacrolimus within one month. RESULTS: Within 6 months, complete remission was achieved in 5 patients (50%) and partial remission in 4 patients (40%), yielding a final response rate of 90%. One patient was primarily resistent to tacrolimus (steroid-refractory minimal-change), another patient became secondarily resistant to tacrolimus after an initial remission (steroid-refractory FSGS). Average proteinuria significantly decreased by 77% from 9.5 +/- 1.4 - 2.2 +/- 1.1 g/day (p \textless 0.01). Serum protein significantly raised from 55.0 +/- 1.9 - 64.6 +/- 1.9 g/l (p \textless 0.01). Tacrolimus induced non-significant increases of blood glucose (4.9 +/- 0.1 - 5.1 +/- 0.2 mmol/l), systolic blood pressure (131.4 +/- 7.1 - 139.0 +/- 7.6 mmHg) and creatinine (93.2 +/- 13.9 103.2 +/- 15.3 mmol/l). Five patients have been tapered off tacrolimus so far, nephrotic syndrome relapsed in 4 of them (80%). Relapse occurred at tacrolimus levels between 2.6 and 6.9 ng/ml. CONCLUSIONS: Our data suggest that tacrolimus may be a promising alternative to cyclosporine both in steroid-resistant and steroid-dependent nephrotic syndrome.
@article{westhoff_tacrolimus_2006,
title = {Tacrolimus in steroid-resistant and steroid-dependent nephrotic syndrome.},
volume = {65},
issn = {0301-0430 0301-0430},
abstract = {BACKGROUND: Steroid resistance and steroid dependence constitute a major problem in the treatment of minimal-change disease and focal segmental glomerulosclerosis (FSGS). Cyclophosphamide and cyclosporine are well-established alternative immunomodulating agents, whereas data on FK 506 (tacrolimus) are rare. METHODS: The present work provides data from 10 patients of an open, monocentric, non-randomized, prospective trial. Five patients with steroid-dependent minimal-change nephrotic syndrome, 1 patient with steroid-refractory minimal-change disease and 4 patients with steroid-refractory FSGS were started on tacrolimus at trough levels of 5 10 microg/l. In case of steroid-dependence, prednisolone was tapered off in presence oftacrolimus within one month. RESULTS: Within 6 months, complete remission was achieved in 5 patients (50\%) and partial remission in 4 patients (40\%), yielding a final response rate of 90\%. One patient was primarily resistent to tacrolimus (steroid-refractory minimal-change), another patient became secondarily resistant to tacrolimus after an initial remission (steroid-refractory FSGS). Average proteinuria significantly decreased by 77\% from 9.5 +/- 1.4 - 2.2 +/- 1.1 g/day (p {\textless} 0.01). Serum protein significantly raised from 55.0 +/- 1.9 - 64.6 +/- 1.9 g/l (p {\textless} 0.01). Tacrolimus induced non-significant increases of blood glucose (4.9 +/- 0.1 - 5.1 +/- 0.2 mmol/l), systolic blood pressure (131.4 +/- 7.1 - 139.0 +/- 7.6 mmHg) and creatinine (93.2 +/- 13.9 103.2 +/- 15.3 mmol/l). Five patients have been tapered off tacrolimus so far, nephrotic syndrome relapsed in 4 of them (80\%). Relapse occurred at tacrolimus levels between 2.6 and 6.9 ng/ml. CONCLUSIONS: Our data suggest that tacrolimus may be a promising alternative to cyclosporine both in steroid-resistant and steroid-dependent nephrotic syndrome.},
language = {eng},
number = {6},
journal = {Clinical nephrology},
author = {Westhoff, T. H. and Schmidt, S. and Zidek, W. and Beige, J. and van der Giet, M.},
month = jun,
year = {2006},
pmid = {16792133},
keywords = {Adult, Blood Glucose/analysis, Blood Pressure/drug effects, Blood Proteins/analysis, Creatinine/urine, Drug Resistance, Drug Therapy, Combination, Female, Glomerulosclerosis, Focal Segmental/drug therapy, Humans, Male, Middle Aged, Nephrosis, Lipoid/drug therapy, Nephrotic Syndrome/*drug therapy, Prednisolone/therapeutic use, Proteinuria/drug therapy, Steroids/pharmacology/*therapeutic use, Tacrolimus/*therapeutic use},
pages = {393--400}
}
Downloads: 0
{"_id":"2Q28qj3mcpEcqFyi2","bibbaseid":"westhoff-schmidt-zidek-beige-vandergiet-tacrolimusinsteroidresistantandsteroiddependentnephroticsyndrome-2006","downloads":0,"creationDate":"2018-02-20T15:51:48.731Z","title":"Tacrolimus in steroid-resistant and steroid-dependent nephrotic syndrome.","author_short":["Westhoff, T. H.","Schmidt, S.","Zidek, W.","Beige, J.","van der Giet, M."],"year":2006,"bibtype":"article","biburl":"https://api.zotero.org/users/15622/collections/LZGXHH9F/items?key=CmkbaMSzICcqq8RIDIpLPL5m&format=bibtex&limit=100","bibdata":{"bibtype":"article","type":"article","title":"Tacrolimus in steroid-resistant and steroid-dependent nephrotic syndrome.","volume":"65","issn":"0301-0430 0301-0430","abstract":"BACKGROUND: Steroid resistance and steroid dependence constitute a major problem in the treatment of minimal-change disease and focal segmental glomerulosclerosis (FSGS). Cyclophosphamide and cyclosporine are well-established alternative immunomodulating agents, whereas data on FK 506 (tacrolimus) are rare. METHODS: The present work provides data from 10 patients of an open, monocentric, non-randomized, prospective trial. Five patients with steroid-dependent minimal-change nephrotic syndrome, 1 patient with steroid-refractory minimal-change disease and 4 patients with steroid-refractory FSGS were started on tacrolimus at trough levels of 5 10 microg/l. In case of steroid-dependence, prednisolone was tapered off in presence oftacrolimus within one month. RESULTS: Within 6 months, complete remission was achieved in 5 patients (50%) and partial remission in 4 patients (40%), yielding a final response rate of 90%. One patient was primarily resistent to tacrolimus (steroid-refractory minimal-change), another patient became secondarily resistant to tacrolimus after an initial remission (steroid-refractory FSGS). Average proteinuria significantly decreased by 77% from 9.5 +/- 1.4 - 2.2 +/- 1.1 g/day (p \\textless 0.01). Serum protein significantly raised from 55.0 +/- 1.9 - 64.6 +/- 1.9 g/l (p \\textless 0.01). Tacrolimus induced non-significant increases of blood glucose (4.9 +/- 0.1 - 5.1 +/- 0.2 mmol/l), systolic blood pressure (131.4 +/- 7.1 - 139.0 +/- 7.6 mmHg) and creatinine (93.2 +/- 13.9 103.2 +/- 15.3 mmol/l). Five patients have been tapered off tacrolimus so far, nephrotic syndrome relapsed in 4 of them (80%). Relapse occurred at tacrolimus levels between 2.6 and 6.9 ng/ml. CONCLUSIONS: Our data suggest that tacrolimus may be a promising alternative to cyclosporine both in steroid-resistant and steroid-dependent nephrotic syndrome.","language":"eng","number":"6","journal":"Clinical nephrology","author":[{"propositions":[],"lastnames":["Westhoff"],"firstnames":["T.","H."],"suffixes":[]},{"propositions":[],"lastnames":["Schmidt"],"firstnames":["S."],"suffixes":[]},{"propositions":[],"lastnames":["Zidek"],"firstnames":["W."],"suffixes":[]},{"propositions":[],"lastnames":["Beige"],"firstnames":["J."],"suffixes":[]},{"propositions":["van","der"],"lastnames":["Giet"],"firstnames":["M."],"suffixes":[]}],"month":"June","year":"2006","pmid":"16792133","keywords":"Adult, Blood Glucose/analysis, Blood Pressure/drug effects, Blood Proteins/analysis, Creatinine/urine, Drug Resistance, Drug Therapy, Combination, Female, Glomerulosclerosis, Focal Segmental/drug therapy, Humans, Male, Middle Aged, Nephrosis, Lipoid/drug therapy, Nephrotic Syndrome/*drug therapy, Prednisolone/therapeutic use, Proteinuria/drug therapy, Steroids/pharmacology/*therapeutic use, Tacrolimus/*therapeutic use","pages":"393--400","bibtex":"@article{westhoff_tacrolimus_2006,\n\ttitle = {Tacrolimus in steroid-resistant and steroid-dependent nephrotic syndrome.},\n\tvolume = {65},\n\tissn = {0301-0430 0301-0430},\n\tabstract = {BACKGROUND: Steroid resistance and steroid dependence constitute a major problem in the treatment of minimal-change disease and focal segmental glomerulosclerosis (FSGS). Cyclophosphamide and cyclosporine are well-established alternative immunomodulating agents, whereas data on FK 506 (tacrolimus) are rare. METHODS: The present work provides data from 10 patients of an open, monocentric, non-randomized, prospective trial. Five patients with steroid-dependent minimal-change nephrotic syndrome, 1 patient with steroid-refractory minimal-change disease and 4 patients with steroid-refractory FSGS were started on tacrolimus at trough levels of 5 10 microg/l. In case of steroid-dependence, prednisolone was tapered off in presence oftacrolimus within one month. RESULTS: Within 6 months, complete remission was achieved in 5 patients (50\\%) and partial remission in 4 patients (40\\%), yielding a final response rate of 90\\%. One patient was primarily resistent to tacrolimus (steroid-refractory minimal-change), another patient became secondarily resistant to tacrolimus after an initial remission (steroid-refractory FSGS). Average proteinuria significantly decreased by 77\\% from 9.5 +/- 1.4 - 2.2 +/- 1.1 g/day (p {\\textless} 0.01). Serum protein significantly raised from 55.0 +/- 1.9 - 64.6 +/- 1.9 g/l (p {\\textless} 0.01). Tacrolimus induced non-significant increases of blood glucose (4.9 +/- 0.1 - 5.1 +/- 0.2 mmol/l), systolic blood pressure (131.4 +/- 7.1 - 139.0 +/- 7.6 mmHg) and creatinine (93.2 +/- 13.9 103.2 +/- 15.3 mmol/l). Five patients have been tapered off tacrolimus so far, nephrotic syndrome relapsed in 4 of them (80\\%). Relapse occurred at tacrolimus levels between 2.6 and 6.9 ng/ml. CONCLUSIONS: Our data suggest that tacrolimus may be a promising alternative to cyclosporine both in steroid-resistant and steroid-dependent nephrotic syndrome.},\n\tlanguage = {eng},\n\tnumber = {6},\n\tjournal = {Clinical nephrology},\n\tauthor = {Westhoff, T. H. and Schmidt, S. and Zidek, W. and Beige, J. and van der Giet, M.},\n\tmonth = jun,\n\tyear = {2006},\n\tpmid = {16792133},\n\tkeywords = {Adult, Blood Glucose/analysis, Blood Pressure/drug effects, Blood Proteins/analysis, Creatinine/urine, Drug Resistance, Drug Therapy, Combination, Female, Glomerulosclerosis, Focal Segmental/drug therapy, Humans, Male, Middle Aged, Nephrosis, Lipoid/drug therapy, Nephrotic Syndrome/*drug therapy, Prednisolone/therapeutic use, Proteinuria/drug therapy, Steroids/pharmacology/*therapeutic use, Tacrolimus/*therapeutic use},\n\tpages = {393--400}\n}\n\n","author_short":["Westhoff, T. H.","Schmidt, S.","Zidek, W.","Beige, J.","van der Giet, M."],"key":"westhoff_tacrolimus_2006","id":"westhoff_tacrolimus_2006","bibbaseid":"westhoff-schmidt-zidek-beige-vandergiet-tacrolimusinsteroidresistantandsteroiddependentnephroticsyndrome-2006","role":"author","urls":{},"keyword":["Adult","Blood Glucose/analysis","Blood Pressure/drug effects","Blood Proteins/analysis","Creatinine/urine","Drug Resistance","Drug Therapy","Combination","Female","Glomerulosclerosis","Focal Segmental/drug therapy","Humans","Male","Middle Aged","Nephrosis","Lipoid/drug therapy","Nephrotic Syndrome/*drug therapy","Prednisolone/therapeutic use","Proteinuria/drug therapy","Steroids/pharmacology/*therapeutic use","Tacrolimus/*therapeutic use"],"downloads":0},"search_terms":["tacrolimus","steroid","resistant","steroid","dependent","nephrotic","syndrome","westhoff","schmidt","zidek","beige","van der giet"],"keywords":["adult","blood glucose/analysis","blood pressure/drug effects","blood proteins/analysis","creatinine/urine","drug resistance","drug therapy","combination","female","glomerulosclerosis","focal segmental/drug therapy","humans","male","middle aged","nephrosis","lipoid/drug therapy","nephrotic syndrome/*drug therapy","prednisolone/therapeutic use","proteinuria/drug therapy","steroids/pharmacology/*therapeutic use","tacrolimus/*therapeutic use"],"authorIDs":[],"dataSources":["qohqQ9ftK9r8G3fNs"]}