What is the treatment of focal segmental glomerulosclerosis

1, treatment
For the treatment of FSGS still controversial past that poor efficacy of this disease, treatment is more difficult, and no mature and effective method of treatment, patients are generally 5 to 10 years into the kidney failure that period. In recent years, a large retrospective study showed a positive result in the removal and treatment of the cause of FSGS, and diuretic, blood pressure and other symptomatic treatment can induce remission of nephrotic syndrome, prevent and delay the progression of the disease. Clinical observations extend FSGS hormone treatments can increase the response rate. At present, for the treatment of patients with FSGS is:

1. glucocorticoid hormone resistance should appear before promptly with prednisone (prednisone) therapy, the dose 0.5 ~ 2.0mg / (kg · d), 6 months. Remission induction dose of at least 60mg / d, 3 months after the reduction to 0.5mg / (kg · d), the average time to complete remission generally get 3 to 4 months. Therefore, the resulting adult FSCS NS after six months of prednisone 1mg / (kg · d) yet remission, it is called hormone resistance. For the elderly, most scholars advocate the next day prednisone 1.0 ~ 1.6mg / (kg · d). For 3 to 5 months. For hormone-dependent resistance and recurrence, intermittent prednisone plus cyclophosphamide pulse therapy can increase the response rate, the total amount of cyclophosphamide should not exceed 12g.

2. cyclosporine (CsA) and cola will be complex (FK506) cyclosporine (CsA) The usual dose 5mg / (kg · d) 6 months of treatment can reduce urinary protein and induce remission, but the reduction or withdrawal often recurrence, therefore, should be long-term use to maintain remission. Renal toxicity due to drug use during serum creatinine should be monitored to adjust the dose accordingly. Coke will resume mechanism with cyclosporine (CsA) is similar to a dose of 0.3mg / (kg · d), can be combined with the hormone. Commonly used in cyclosporine (CsA) therapy or dependent.

3. cytotoxic drugs (cyclophosphamide and chlorambucil oxygen mustard) can be used as two treatments, but its efficacy remains to be confirmed by clinical observation. Banfi, etc. In a retrospective study of patients with FSGS with NS, the patients were divided into three groups, A group was treated with prednisone (prednisone), group B prednisone (prednisone) 1mg / (kg · d ) and chlorambucil, cyclophosphamide or azathioprine in combination with group C with a small dose [0.2 ~ 0.3mg / (kg · d)] prednisone (prednisone) and azathioprine or cyclophosphamide amide MS. Three groups remission rate was 74%, 58% and 38%, respectively. However, the recurrence rate in group A, while the application of cytotoxic drugs recurrence rate of treatment. Tarshish et al reported a prospective study comparing 60 cases of children alone with prednisone (prednisone) and prednisone (prednisone) plus cyclophosphamide 2.5mg / (kg · d) the effect of the two groups did not differ efficient. These data suggest that: the use of hormones or hormone alone with cytotoxic drugs combined, there was no significant difference