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    In With: Children Nephrotic

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    The document compares oral and intravenous cyclophosphamide in treating children with steroid-resistant nephrotic syndrome. It finds that intravenous cyclophosphamide is more effective at inducing remission. The study also notes that steroid-resistant nephrotic syndrome carries risks of extra-renal complications if left untreated.

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    In With: Children Nephrotic

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    marwicute
    23 views1 page
    The document compares oral and intravenous cyclophosphamide in treating children with steroid-resistant nephrotic syndrome. It finds that intravenous cyclophosphamide is more effective at inducing remission. The study also notes that steroid-resistant nephrotic syndrome carries risks of extra-renal complications if left untreated.

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    The document compares oral and intravenous cyclophosphamide in treating children with steroid-resistant nephrotic syndrome. It finds that intravenous cyclophosphamide is more effective at inducing remission. The study also notes that steroid-resistant nephrotic syndrome carries risks of extra-renal complications if left untreated.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    23 views1 page

    In With: Children Nephrotic

    Uploaded by

    marwicute
    The document compares oral and intravenous cyclophosphamide in treating children with steroid-resistant nephrotic syndrome. It finds that intravenous cyclophosphamide is more effective at inducing remission. The study also notes that steroid-resistant nephrotic syndrome carries risks of extra-renal complications if left untreated.

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    Paediatrica Indonesiana

    NUMBER5

    September. 2011

    VOLUME5l

    Comparison of oral and intravenous cyclophosphamide


    in children with steroid.rsistart nephrotic syndrome
    Eka Laksmi Hidayati, Sudung O Pardede, Pardni

    Trihono

    ephrotic syndrome (NS) is the most

    Abstract
    Background Although phototherapy has been used in clinical
    practice for 40 years, there is still much debate on how to provide
    the most efficacious phototherapy. Phototherapy with white
    reflecting curtains may increase the average spectral irradiance
    provided, as well as decrease serum bilirubin concentrations at a
    faster rate in neonates with jaundice.
    Objectiue To determine if adding low cost, white, reflecting

    curtains to a standard phototherapy unit can increase the


    effectiveness of phototherapy for neonatal jaundice.
    Metlwds A randomized, controlled, open trial was conducted at

    H. Adam Malik and Pimgadi Hospitals, Medan, from May to


    December 2009. The criteria for inclusion in the study were full
    term newboms with neonatal laundice presenting in their first
    week of life. Single phototherapy with white curtains hanging
    from the sides of the phototherapy unit (study group, n:30)
    was compared to single phototherapy without curtains (control
    group, n:30). The primary outcomes measured were the mean
    difference in total serum bilirubin levels and average spectral
    irradiation levels measured at baseline, and after 12 hours and
    24 hours of phototherapy.
    Revrlts The sum of average spectral irradiance in the curtained
    phototherapy unit was significantly higher than that of the
    standard phototherapy unit without curtains (P < 0.05). The
    decrease of total serum bilirubin levels after 12 and 24 hours of
    phototherapy was significantly greater in the study group (3.71
    and 9.7 mg/dl, respectively) than in the control group (0.1 and
    3.8 mg/dl, respectively), both P <0.05.
    Conclusion $Vhite, reflecting curtains in phototherapy units
    was significantly more effective than phototherapy without
    curtains for treatment of neonatal jaundice. [Paediatr Indones.

    20lt;512266.711.

    frequent glomerular disease in childhood.

    Most pediatric patients respond to


    corticosteroid therapy, but 10% of them
    fail to respond to this treatment. Resistance to
    corticosteroids has been shown to be a risk for extra.

    renal complications of NS, with half progressing


    to end-stage renal disease (ESRD) within 5 years,
    constituting about 10o/o of ESRD in children.l Thus, in
    SRNS, the need for an altemative immunosuppressive
    treatment is mandatory.

    Various therapeutic options are available,


    including cyclophosphamide (CPA), cyclosporine,
    intravenous methylprednisolone, angiotensinconverting enzyme inhibitors (ACE-I) and myco
    phenolate mofetil.z,3 Most studies have reported
    a success rate of 50-60Vo, There are, however,
    treatment modes,
    considerable differences
    combinations and dosage regimens among these
    agents.z A suitable combination with the least toxicity
    remains to be determined.

    From the Department of Child Health, University of Indonesia Medical


    School, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

    Reprint requests to: Eka Laksmi Hidayati, MD, Pediatrician, Division of

    Keyurords: steroid-resistant nephrotic syndrone,


    cyclophosphamide

    266 .

    P-

    Vol. 51, No.

    -5, September

    2011

    PediatricNephrology, Department of Child Health, University of Indonesia


    Medical School, Cipto Mangunkusumo Hospital, Jl. Diponegoro No. 71,
    Jakarta 10430, Indonesia. Tel. +62-21-391 5179. E-mail: eka.laksmi@
    ui.ac.id

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