Morbidity in children with frequently relapsing nephrosis: 10-year follow-up of a randomized controlled trial
Background To investigate the long-term outcome in children with frequently relapsing nephrotic syndrome (FRNS) we conducted a follow-up of a previous randomized controlled trial (RCT) 10 years after the initiation of the treatment protocol. Methods We previously conducted an RCT on the efficacy of...
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| Veröffentlicht in: | Pediatric nephrology (Berlin, West) West), 2015-03, Vol.30 (3), p.459-468 |
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| creator | Ishikura, Kenji Yoshikawa, Norishige Nakazato, Hitoshi Sasaki, Satoshi Nakanishi, Koichi Matsuyama, Takeshi Ito, Shuichi Hamasaki, Yuko Yata, Nahoko Ando, Takashi Iijima, Kazumoto Honda, Masataka |
| description | Background
To investigate the long-term outcome in children with frequently relapsing nephrotic syndrome (FRNS) we conducted a follow-up of a previous randomized controlled trial (RCT) 10 years after the initiation of the treatment protocol.
Methods
We previously conducted an RCT on the efficacy of cyclosporine for treating children with FRNS. After 2 years of treatment, a recommended a management protocol of steroids, and immunosuppressants was provided.
Results
Valid information was available for 46 of the 56 patients (82.1 %) enrolled in the original RCT. The median follow-up period was 10.3 years from the start of protocol treatment with cyclosporine. At last follow-up (mean age 18.7 years), only ten patients (21.7 %) showed disease-free remission (no relapse for at least 2 years). In contrast, 23 (50.0 %) continued to relapse frequently or were on immunosuppressants, eight patients (17.4 %) had infrequent relapses without immunosuppressants. Adverse effects attributable to treatment included short stature (6 patients), osteoporosis (six patients), obesity (4 patients), cataracts (3 patients) and hypertension (3 patients). No lethal event or renal dysfunction occurred during follow-up.
Conclusions
This 10-year follow-up study shows that most children with FRNS experience relapses after 2 years of cyclosporine treatment, in adolescence and into adulthood. Outcomes in terms of life expectancy and renal function are favorable. |
| doi_str_mv | 10.1007/s00467-014-2955-8 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1652442644</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A407528379</galeid><sourcerecordid>A407528379</sourcerecordid><originalsourceid>FETCH-LOGICAL-c578t-de0d7ccd2e0406b2638dd18e133b53e29da262cdc72a52eef3d93b8f0d3b5e9f3</originalsourceid><addsrcrecordid>eNp1kltrFTEUhQdR7LH6A3yRgFB8Sc1lLhnfSvEGFV8U-hYyyZ4zKZlkTDKU4683h1O1lSN5SMj-1mJnZ1XVS0rOKSHd20RI3XaY0BqzvmmweFRtaM0Zpr24flxtSM8pJjW9PqmepXRDCBGNaJ9WJ6xhXdf03aaav4Q4WGPzDlmP9GSdieDRrc0TGiP8WMFnt0MRnFqS9VvkYZliSDa9Q5TgHaiIxuBcuMXrgsKIFIrKmzDbn2CQDj7HUi3HHK1yz6sno3IJXtztp9X3D--_XX7CV18_fr68uMK66UTGBojptDYMSE3agbVcGEMFUM6HhgPrjWIt00Z3TDUMYOSm54MYiSl16Ed-Wr05-C4xlCekLGebNDinPIQ1Sdo2rK5ZW9cFff0PehPW6Et3e4pwwRht_1Jb5UBaP4Ycld6byouadA0TvOsLhY9QW_AQlQseRluuH_DnR_iyDMxWHxWc3RNMoFyeUnBrtsGnhyA9gLr8VYowyiXaWcWdpETusyMP2ZElO3KfHSmK5tXdJNZhBvNH8TssBWAHIJWS30K8N6r_uv4C8l3NoQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1650382216</pqid></control><display><type>article</type><title>Morbidity in children with frequently relapsing nephrosis: 10-year follow-up of a randomized controlled trial</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Ishikura, Kenji ; Yoshikawa, Norishige ; Nakazato, Hitoshi ; Sasaki, Satoshi ; Nakanishi, Koichi ; Matsuyama, Takeshi ; Ito, Shuichi ; Hamasaki, Yuko ; Yata, Nahoko ; Ando, Takashi ; Iijima, Kazumoto ; Honda, Masataka</creator><creatorcontrib>Ishikura, Kenji ; Yoshikawa, Norishige ; Nakazato, Hitoshi ; Sasaki, Satoshi ; Nakanishi, Koichi ; Matsuyama, Takeshi ; Ito, Shuichi ; Hamasaki, Yuko ; Yata, Nahoko ; Ando, Takashi ; Iijima, Kazumoto ; Honda, Masataka ; Japanese Study Group of Renal Disease in Children ; for Japanese Study Group of Renal Disease in Children</creatorcontrib><description>Background
To investigate the long-term outcome in children with frequently relapsing nephrotic syndrome (FRNS) we conducted a follow-up of a previous randomized controlled trial (RCT) 10 years after the initiation of the treatment protocol.
Methods
We previously conducted an RCT on the efficacy of cyclosporine for treating children with FRNS. After 2 years of treatment, a recommended a management protocol of steroids, and immunosuppressants was provided.
Results
Valid information was available for 46 of the 56 patients (82.1 %) enrolled in the original RCT. The median follow-up period was 10.3 years from the start of protocol treatment with cyclosporine. At last follow-up (mean age 18.7 years), only ten patients (21.7 %) showed disease-free remission (no relapse for at least 2 years). In contrast, 23 (50.0 %) continued to relapse frequently or were on immunosuppressants, eight patients (17.4 %) had infrequent relapses without immunosuppressants. Adverse effects attributable to treatment included short stature (6 patients), osteoporosis (six patients), obesity (4 patients), cataracts (3 patients) and hypertension (3 patients). No lethal event or renal dysfunction occurred during follow-up.
Conclusions
This 10-year follow-up study shows that most children with FRNS experience relapses after 2 years of cyclosporine treatment, in adolescence and into adulthood. Outcomes in terms of life expectancy and renal function are favorable.</description><identifier>ISSN: 0931-041X</identifier><identifier>EISSN: 1432-198X</identifier><identifier>DOI: 10.1007/s00467-014-2955-8</identifier><identifier>PMID: 25277597</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Analysis ; Biopsy ; Care and treatment ; Child ; Child development ; Clinical trials ; Cyclosporine - therapeutic use ; Diagnosis ; Drug dosages ; Female ; Follow-Up Studies ; Humans ; Immunosuppressive agents ; Immunosuppressive Agents - therapeutic use ; Kidney diseases ; Life expectancy ; Male ; Medicine ; Medicine & Public Health ; Morbidity ; Nephrology ; Nephrotic syndrome ; Nephrotic Syndrome - complications ; Nephrotic Syndrome - drug therapy ; Original Article ; Patients ; Pediatrics ; Prospective Studies ; Recurrence ; Remission (Medicine) ; Steroids ; Time Factors ; Toxicity ; Urology</subject><ispartof>Pediatric nephrology (Berlin, West), 2015-03, Vol.30 (3), p.459-468</ispartof><rights>IPNA 2014</rights><rights>COPYRIGHT 2015 Springer</rights><rights>IPNA 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c578t-de0d7ccd2e0406b2638dd18e133b53e29da262cdc72a52eef3d93b8f0d3b5e9f3</citedby><cites>FETCH-LOGICAL-c578t-de0d7ccd2e0406b2638dd18e133b53e29da262cdc72a52eef3d93b8f0d3b5e9f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00467-014-2955-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00467-014-2955-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25277597$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ishikura, Kenji</creatorcontrib><creatorcontrib>Yoshikawa, Norishige</creatorcontrib><creatorcontrib>Nakazato, Hitoshi</creatorcontrib><creatorcontrib>Sasaki, Satoshi</creatorcontrib><creatorcontrib>Nakanishi, Koichi</creatorcontrib><creatorcontrib>Matsuyama, Takeshi</creatorcontrib><creatorcontrib>Ito, Shuichi</creatorcontrib><creatorcontrib>Hamasaki, Yuko</creatorcontrib><creatorcontrib>Yata, Nahoko</creatorcontrib><creatorcontrib>Ando, Takashi</creatorcontrib><creatorcontrib>Iijima, Kazumoto</creatorcontrib><creatorcontrib>Honda, Masataka</creatorcontrib><creatorcontrib>Japanese Study Group of Renal Disease in Children</creatorcontrib><creatorcontrib>for Japanese Study Group of Renal Disease in Children</creatorcontrib><title>Morbidity in children with frequently relapsing nephrosis: 10-year follow-up of a randomized controlled trial</title><title>Pediatric nephrology (Berlin, West)</title><addtitle>Pediatr Nephrol</addtitle><addtitle>Pediatr Nephrol</addtitle><description>Background
To investigate the long-term outcome in children with frequently relapsing nephrotic syndrome (FRNS) we conducted a follow-up of a previous randomized controlled trial (RCT) 10 years after the initiation of the treatment protocol.
Methods
We previously conducted an RCT on the efficacy of cyclosporine for treating children with FRNS. After 2 years of treatment, a recommended a management protocol of steroids, and immunosuppressants was provided.
Results
Valid information was available for 46 of the 56 patients (82.1 %) enrolled in the original RCT. The median follow-up period was 10.3 years from the start of protocol treatment with cyclosporine. At last follow-up (mean age 18.7 years), only ten patients (21.7 %) showed disease-free remission (no relapse for at least 2 years). In contrast, 23 (50.0 %) continued to relapse frequently or were on immunosuppressants, eight patients (17.4 %) had infrequent relapses without immunosuppressants. Adverse effects attributable to treatment included short stature (6 patients), osteoporosis (six patients), obesity (4 patients), cataracts (3 patients) and hypertension (3 patients). No lethal event or renal dysfunction occurred during follow-up.
Conclusions
This 10-year follow-up study shows that most children with FRNS experience relapses after 2 years of cyclosporine treatment, in adolescence and into adulthood. Outcomes in terms of life expectancy and renal function are favorable.</description><subject>Analysis</subject><subject>Biopsy</subject><subject>Care and treatment</subject><subject>Child</subject><subject>Child development</subject><subject>Clinical trials</subject><subject>Cyclosporine - therapeutic use</subject><subject>Diagnosis</subject><subject>Drug dosages</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Immunosuppressive agents</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Kidney diseases</subject><subject>Life expectancy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Morbidity</subject><subject>Nephrology</subject><subject>Nephrotic syndrome</subject><subject>Nephrotic Syndrome - complications</subject><subject>Nephrotic Syndrome - drug therapy</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Prospective Studies</subject><subject>Recurrence</subject><subject>Remission (Medicine)</subject><subject>Steroids</subject><subject>Time Factors</subject><subject>Toxicity</subject><subject>Urology</subject><issn>0931-041X</issn><issn>1432-198X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kltrFTEUhQdR7LH6A3yRgFB8Sc1lLhnfSvEGFV8U-hYyyZ4zKZlkTDKU4683h1O1lSN5SMj-1mJnZ1XVS0rOKSHd20RI3XaY0BqzvmmweFRtaM0Zpr24flxtSM8pJjW9PqmepXRDCBGNaJ9WJ6xhXdf03aaav4Q4WGPzDlmP9GSdieDRrc0TGiP8WMFnt0MRnFqS9VvkYZliSDa9Q5TgHaiIxuBcuMXrgsKIFIrKmzDbn2CQDj7HUi3HHK1yz6sno3IJXtztp9X3D--_XX7CV18_fr68uMK66UTGBojptDYMSE3agbVcGEMFUM6HhgPrjWIt00Z3TDUMYOSm54MYiSl16Ed-Wr05-C4xlCekLGebNDinPIQ1Sdo2rK5ZW9cFff0PehPW6Et3e4pwwRht_1Jb5UBaP4Ycld6byouadA0TvOsLhY9QW_AQlQseRluuH_DnR_iyDMxWHxWc3RNMoFyeUnBrtsGnhyA9gLr8VYowyiXaWcWdpETusyMP2ZElO3KfHSmK5tXdJNZhBvNH8TssBWAHIJWS30K8N6r_uv4C8l3NoQ</recordid><startdate>20150301</startdate><enddate>20150301</enddate><creator>Ishikura, Kenji</creator><creator>Yoshikawa, Norishige</creator><creator>Nakazato, Hitoshi</creator><creator>Sasaki, Satoshi</creator><creator>Nakanishi, Koichi</creator><creator>Matsuyama, Takeshi</creator><creator>Ito, Shuichi</creator><creator>Hamasaki, Yuko</creator><creator>Yata, Nahoko</creator><creator>Ando, Takashi</creator><creator>Iijima, Kazumoto</creator><creator>Honda, Masataka</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20150301</creationdate><title>Morbidity in children with frequently relapsing nephrosis: 10-year follow-up of a randomized controlled trial</title><author>Ishikura, Kenji ; Yoshikawa, Norishige ; Nakazato, Hitoshi ; Sasaki, Satoshi ; Nakanishi, Koichi ; Matsuyama, Takeshi ; Ito, Shuichi ; Hamasaki, Yuko ; Yata, Nahoko ; Ando, Takashi ; Iijima, Kazumoto ; Honda, Masataka</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c578t-de0d7ccd2e0406b2638dd18e133b53e29da262cdc72a52eef3d93b8f0d3b5e9f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Analysis</topic><topic>Biopsy</topic><topic>Care and treatment</topic><topic>Child</topic><topic>Child development</topic><topic>Clinical trials</topic><topic>Cyclosporine - therapeutic use</topic><topic>Diagnosis</topic><topic>Drug dosages</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Immunosuppressive agents</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Kidney diseases</topic><topic>Life expectancy</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Morbidity</topic><topic>Nephrology</topic><topic>Nephrotic syndrome</topic><topic>Nephrotic Syndrome - complications</topic><topic>Nephrotic Syndrome - drug therapy</topic><topic>Original Article</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Prospective Studies</topic><topic>Recurrence</topic><topic>Remission (Medicine)</topic><topic>Steroids</topic><topic>Time Factors</topic><topic>Toxicity</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ishikura, Kenji</creatorcontrib><creatorcontrib>Yoshikawa, Norishige</creatorcontrib><creatorcontrib>Nakazato, Hitoshi</creatorcontrib><creatorcontrib>Sasaki, Satoshi</creatorcontrib><creatorcontrib>Nakanishi, Koichi</creatorcontrib><creatorcontrib>Matsuyama, Takeshi</creatorcontrib><creatorcontrib>Ito, Shuichi</creatorcontrib><creatorcontrib>Hamasaki, Yuko</creatorcontrib><creatorcontrib>Yata, Nahoko</creatorcontrib><creatorcontrib>Ando, Takashi</creatorcontrib><creatorcontrib>Iijima, Kazumoto</creatorcontrib><creatorcontrib>Honda, Masataka</creatorcontrib><creatorcontrib>Japanese Study Group of Renal Disease in Children</creatorcontrib><creatorcontrib>for Japanese Study Group of Renal Disease in Children</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric nephrology (Berlin, West)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ishikura, Kenji</au><au>Yoshikawa, Norishige</au><au>Nakazato, Hitoshi</au><au>Sasaki, Satoshi</au><au>Nakanishi, Koichi</au><au>Matsuyama, Takeshi</au><au>Ito, Shuichi</au><au>Hamasaki, Yuko</au><au>Yata, Nahoko</au><au>Ando, Takashi</au><au>Iijima, Kazumoto</au><au>Honda, Masataka</au><aucorp>Japanese Study Group of Renal Disease in Children</aucorp><aucorp>for Japanese Study Group of Renal Disease in Children</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Morbidity in children with frequently relapsing nephrosis: 10-year follow-up of a randomized controlled trial</atitle><jtitle>Pediatric nephrology (Berlin, West)</jtitle><stitle>Pediatr Nephrol</stitle><addtitle>Pediatr Nephrol</addtitle><date>2015-03-01</date><risdate>2015</risdate><volume>30</volume><issue>3</issue><spage>459</spage><epage>468</epage><pages>459-468</pages><issn>0931-041X</issn><eissn>1432-198X</eissn><abstract>Background
To investigate the long-term outcome in children with frequently relapsing nephrotic syndrome (FRNS) we conducted a follow-up of a previous randomized controlled trial (RCT) 10 years after the initiation of the treatment protocol.
Methods
We previously conducted an RCT on the efficacy of cyclosporine for treating children with FRNS. After 2 years of treatment, a recommended a management protocol of steroids, and immunosuppressants was provided.
Results
Valid information was available for 46 of the 56 patients (82.1 %) enrolled in the original RCT. The median follow-up period was 10.3 years from the start of protocol treatment with cyclosporine. At last follow-up (mean age 18.7 years), only ten patients (21.7 %) showed disease-free remission (no relapse for at least 2 years). In contrast, 23 (50.0 %) continued to relapse frequently or were on immunosuppressants, eight patients (17.4 %) had infrequent relapses without immunosuppressants. Adverse effects attributable to treatment included short stature (6 patients), osteoporosis (six patients), obesity (4 patients), cataracts (3 patients) and hypertension (3 patients). No lethal event or renal dysfunction occurred during follow-up.
Conclusions
This 10-year follow-up study shows that most children with FRNS experience relapses after 2 years of cyclosporine treatment, in adolescence and into adulthood. Outcomes in terms of life expectancy and renal function are favorable.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>25277597</pmid><doi>10.1007/s00467-014-2955-8</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0931-041X |
| ispartof | Pediatric nephrology (Berlin, West), 2015-03, Vol.30 (3), p.459-468 |
| issn | 0931-041X 1432-198X |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Analysis Biopsy Care and treatment Child Child development Clinical trials Cyclosporine - therapeutic use Diagnosis Drug dosages Female Follow-Up Studies Humans Immunosuppressive agents Immunosuppressive Agents - therapeutic use Kidney diseases Life expectancy Male Medicine Medicine & Public Health Morbidity Nephrology Nephrotic syndrome Nephrotic Syndrome - complications Nephrotic Syndrome - drug therapy Original Article Patients Pediatrics Prospective Studies Recurrence Remission (Medicine) Steroids Time Factors Toxicity Urology |
| title | Morbidity in children with frequently relapsing nephrosis: 10-year follow-up of a randomized controlled trial |
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