Clinical Drug Investigation

, Volume 16, Issue 3, pp 211–218 | Cite as

Immunosuppressive Treatment for Idiopathic Nephrotic Syndrome with Corticosteroids and Cyclophosphamide

Factors Associated with a Favourable Outcome
  • Mario Pirisi
  • Rossana Faedda
  • Andrea Satta
  • Ettore Bartoli
Clinical Use


Objective: We report the results of a combined immunosuppressive schedule for the treatment of patients with idiopathic nephrotic syndrome, in which prednisone and cyclophosphamide were given in four phases: induction, maintenance, tapering and discontinuation.

Patients and Outcome Measures: Sixty-seven patients with nephrotic syndrome, followed for an average of 7.1 ± 4.5 years, were studied. Treatment outcomes were remission, progression, end-stage renal disease and death.

Results: At the end of the follow-up, 72% of patients maintained a complete remission. Stepwise logistic regression showed that the cumulative dose of cyclophosphamide was the only independent predictor of a favourable outcome, being associated both with complete remission of the nephrotic syndrome and with lack of progression to chronic renal failure.

Conclusion: We suggest that the combination treatment may be indicated in all histological subgroups of nephrotic syndrome, provided that prednisone is given at high doses on alternate days, cyclophosphamide is given for 6 months, and relapses are treated with the same schedule. The adverse effects of treatment, however, require the adoption of a programme to prevent bone loss, infertility, bladder cancer and infections.


Adis International Limited Nephrotic Syndrome Chronic Renal Failure Plasma Creatinine Azoospermia 
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Copyright information

© Adis International Limited 1998

Authors and Affiliations

  • Mario Pirisi
    • 1
  • Rossana Faedda
    • 2
  • Andrea Satta
    • 2
  • Ettore Bartoli
    • 1
  1. 1.Cattedra di Medicina Interna, DPMSCUniversità degli StudiUdineItaly
  2. 2.Istituto di Patologia MedicaUniversità degli StudiSassariItaly

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