Evaluation of the general therapies in the treatment of the adult patients with primary nephrotic syndrome

ABSTRACT

Background: Primary nephrotic syndrome in adult patients is a common sign of patients with primary glomerular disease. Objective: To evaluate the responsiveness of adult patients with primary nephrotic syndrome to corticosteroid alone or in combination with cyclophosphamid and the treatment - related complications. Subjects and method: Based on pathological findings 91 patients with primary nephrotic syndrome divided into 2 groups group 1 (75 patients) were assigned to receive corticosteroid alone at 1 mg/kg/day, group 2 (16 patients) were assigned to receive the corticosteroid at 0.5 mg/kg/day and cyclophosphamid at 2 mg/kg/day. 11 non - responders from group 1 were switched to group 2 after 6 months of treatment by \r\n', u'corticosteroid alone. The response to therapy was assessed after 3 months and 6 months of treatment. Results:In group 1 the number of patients responding to corticosteroid alone was increasing from 38 after 3 months to 50 after 6 months. In group 2 the number of patients responding to combined protocol was increasing from 4 (14.8%) to 12 (44.4%). The most frequently seen corticosteroid - related complication was cushingoid which is reversible after reducing dose or stop treatment. Severe complications were not common. For the whole group taking cyclophosphamid leucocytopenia, was seen in 4/27 (14.8%) patients, in subgroup of women hypo - amenorrhea was observed in 3/15 (20%) of cases. Conclusions: Results of study encourage the prolongation of treatment. Sterility and if possible preventive measures should be taken into consideration when cyclophosphamid is selected for young patients in reproductive age.\r\n', u'