ABSTRACT
Objective: To determine the short-term outcome of cyclophosphamide [CPO] course in children with relapsing steroid sensitive nephrotic syndrome [SSNS] with different histopathological lesions
Study Design: Descriptive, observational study
Place and Duration of Study: Pediatric Nephrology Department, Sindh Institute of Urology and Transplantation, Karachi, from January 2012 to December 2014
Methodology: All children with relapsing steroid-sensitive nephrotic syndrome, who underwent renal biopsy and received cyclophosphamide therapy, were included and followed up for 2 years. Histopathological features in renal biopsy, duration of treatment, duration of complete remission and complication frequency was noted
Results: Of the total 74 patients, 47 [63.5%] were males and 27 [36.5%] females. Median age with Interquartile range [IQR] at presentation was 5 years [4-7 years]. Minimal change disease [MCD] was the most common histopathological diagnosis [n=54, 73%] followed by focal segmental glomerulosclerosis [FSGS] [n=13, 17.5%], mesangioproliferative glomerulonephritis [MesPGN] [n=6, 8.1%], IgA nephropathy [n=1, 1.4%]. The median number of glomeruli included in each biopsy sample was 15. The median duration of treatment with CPO was 11 weeks [9 to 13 weeks], whereas the median duration of complete remission post-therapy was 13 months [7-23 months]. A median timeframe of 17 months [13-24.2 months] lapsed between establishing the diagnosis of NS and initiating CPO treatment. Leucopenia was noted in six [8.1%] patients
Conclusion: The short-term outcome of relapsing SSNS can be improved with CPO and steroids, with minimum short-term side effects