Steroid Minimization in Adults with Minimal Change Disease

Abstract

<b><i>Background:</i></b> Minimal change disease (MCD) causes approximately 10% of nephrotic syndrome in adults. While glucocorticoids (GCs) effectively induce remission in MCD, the disease has a high relapse rate (50–75%), and repeated exposure to GCs is often required. The adverse effects of GCs are well recognized and commonly encountered with the high doses and recurrent courses used in MCD. <b><i>Summary:</i></b> In this review, we will discuss the standard therapy of MCD in adults and then describe new therapeutic options in induction therapy and treatment of relapses in MCD, minimizing the exposure to GCs. <b><i>Key Messages:</i></b> Steroid minimization strategies may decrease adverse effects in the treatment of MCD.

Steroid-Dependent Nephrotic Syndrome in a Child After an Allogeneic Bone Marrow Transplant: A Case Report

“…However, for individuals with frequent relapses, who are steroid-dependent, or in whom steroids are contraindicated or not recommended, the addition of immunosuppressive therapy (levamisole, calcineurin inhibitors, mycophenolate mofetil, cyclophosphamide, or rituximab) as steroidsparing therapy is recommended, in order to minimise steroid doses. 7,8 GvHD is a life-threatening complication in patients after a bone marrow transplant due to immune dysregulation. 9 It can be acute GvHD less than 100 days post-transplant, or chronic GvHD more than 100 days post-transplant.…”

SEBUAH LAPORAN KASUS Sindrom Nefrotik pada Pasien Pengguna Obat Antiinflamasi Non Steroid (OAINS) pada Dewasa: sebuah Laporan Kasus

“…(14) (14,15) Namun penggunaan steroid jangka lama memiliki berbagai macam efek samping seperti infeksi, penyakit tulang, obesitas, hipertensi, psikosis, perdarahan saluran cerna, katarak, disglikemia, dan risiko penyakit kardiovaskular jangka panjang. (15) Namun dengan tujuan memperpendek Tappering off dilakukan selama 6 minggu berikutnya, pastikan pasien mendapatkan terapi minimal 16 minggu. (15) Tatalaksana utama pada kasus SN terkait OAINS adalah menghentikan konsumsi OAINS pada pasien.…”

“…(15) Namun dengan tujuan memperpendek Tappering off dilakukan selama 6 minggu berikutnya, pastikan pasien mendapatkan terapi minimal 16 minggu. (15) Tatalaksana utama pada kasus SN terkait OAINS adalah menghentikan konsumsi OAINS pada pasien. Penghentian OAINS selama 2 tahun terbukti memperbaiki kondisi pasien.…”