RESPONSE TO CYCLOPHOSPHAMIDE THERAPY IN SAUDI CHILDREN WITH IDIOPATHIC NEPHROTIC SYNDROME

Thirty-three children with idiopathic nephrotic syndrome received an eight-week course of 2.5 to 3.0 mg/kg of body weight of cycloposphamide. Twenty-five (76%) were in remission 12 to 28 months later (mean, 21.8 months). Those in remission included 77% of the patients with mesangioproliferative glomerulonephritis, 70% of the patients with focal segmental glomerulosclerosis, and 78% of the patients with minimal change nephropathy. In terms of steroid sensitivity, 37.5% of the patients with early steroid resistance were in remission, compared with 100% of the patients with late steroid resistance and 86% of those who were steroid dependent and had frequent relapses. Cyclophosphamide therapy should be considered in patients who become resistant to corticosteroids after an initial response and in those who have frequent relapses and need a toxic dose of steroids to remain in remission. Response to such therapy correlates better with the patient's response to the preceding prednisolone therapy rather than to the renal histology.