EFFECT OF IMMUNOSUPPRESSIVE REGIMENS ON THE RELAPSE RATE AND CUMULATIVE CORTICOSTEROID DOSE IN CHILDREN WITH FREQUENTLY RECURRENT NEPHROTIC SYNDROME
Keywords:
pediatric nephrotic syndrome, tacrolimus, mycophenolate mofetil, steroid‑dependent nephrotic syndromeAbstract
Background: Frequently relapsing nephrotic syndrome (FRNS) represent major challenges in pediatric nephrology due to repeated relapses and prolonged corticosteroid therapy that may cause significant adverse effects.
Objective: To evaluate the effectiveness of two mycophenolate‑based immunosuppressive regimens in reducing relapse frequency and cumulative corticosteroid exposure in children with FRNS.
Methods: A prospective cohort study included 89 children with nephrotic syndrome. Patients were treated with either mycophenolate mofetil (MMF) + tacrolimus + prednisolone (n=34) or mycophenolate mofetil + prednisolone (n=55). Clinical variables analyzed included relapse frequency, cumulative prednisolone dose, demographic characteristics, and histopathological findings.
Results: Both treatment regimens were associated with a significant reduction in relapse frequency and cumulative steroid exposure. Mean relapse number decreased from 6.7 to 2.0 episodes in the triple‑therapy group and from 3.9 to 0.9 episodes in the MMF + prednisolone group.
Conclusion: Mycophenolate‑based immunosuppressive therapy significantly reduces relapse frequency and corticosteroid exposure in children with FRNS.
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