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Meta-Analysis
. 2008 Jan 23;2008(1):CD001537.
doi: 10.1002/14651858.CD001537.pub4.

Interventions for minimal change disease in adults with nephrotic syndrome

S C Palmer  1 , K Nand, G F Strippoli
Affiliations
Meta-Analysis

Interventions for minimal change disease in adults with nephrotic syndrome

S C Palmer et al. Cochrane Database Syst Rev. .

Update in

Abstract

Background: Steroids have been used widely since the early 1970s for the treatment of adult-onset minimal change disease. The response rates to immunosuppressive agents in adult minimal change disease, especially steroids, are more variable than in children. The optimal agent, dose, and duration of treatment for the first episode of nephrotic syndrome, or for disease relapse(s) has not been determined.

Objectives: To determine the benefits and harms of interventions for the nephrotic syndrome in adults caused by minimal change disease.

Search strategy: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, reference articles and abstracts from conference proceedings, without language restriction. Search date: January 2007.

Selection criteria: Randomised controlled trials (RCTs) and quasi-RCTs of any intervention for minimal change disease in adults over 18 years with the nephrotic syndrome were included. Studies comparing different routes, frequencies, and duration of immunosuppressive agents were selected. Studies comparing non-immunosuppressive agents were also assessed.

Data collection and analysis: Two authors independently assessed study quality and extracted data. Statistical analyses were performed using the random effects model and results were expressed as a relative risk (RR) for dichotomous outcomes, or mean difference (WMD) for continuous data with 95% confidence intervals (CI).

Main results: Three RCTs (68 participants) were identified. All treatment comparisons contained only one study. No significant difference was found between prednisone compared with placebo for complete (RR 1.44, CI 0.95 to 2.19) and partial remission (RR 1.00, CI 0.07 to 14.45) of the nephrotic syndrome due to minimal change disease. There was no difference between intravenous methylprednisolone plus oral prednisone compared with oral prednisone alone for complete remission (RR 0.74, CI 0.50 to 1.08). Prednisone, compared with short-course intravenous methylprednisolone, increased the number of subjects who achieved complete remission (RR 4.95, CI 1.15 to 21.26). The lack of statistical evidence of efficacy associated with prednisone therapy was based on data derived from a single study that compared 'alternate-day prednisone' to no immunosuppression' with only a small number of participants in each group. No RCTs were identified comparing regimens in adults with a steroid-dependent or relapsing disease course or comparing treatments comprising alkylating agents, cyclosporine, tacrolimus, levamisole, or mycophenolate mofetil.

Authors' conclusions: Further comparative studies are required to examine the efficacy of immunosuppressive agents for achievement of sustained remission of nephrotic syndrome caused by minimal change disease. Studies are also needed to evaluate treatments for adults with steroid-dependent or relapsing disease.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1
1
Flow chart of study identification and selection
1.1
1.1. Analysis
Comparison 1 Steroid versus placebo or no treatment, Outcome 1 Complete remission.
1.2
1.2. Analysis
Comparison 1 Steroid versus placebo or no treatment, Outcome 2 Partial remission.
1.3
1.3. Analysis
Comparison 1 Steroid versus placebo or no treatment, Outcome 3 Sustained remission during follow‐up.
1.4
1.4. Analysis
Comparison 1 Steroid versus placebo or no treatment, Outcome 4 Loss of oedema.
1.5
1.5. Analysis
Comparison 1 Steroid versus placebo or no treatment, Outcome 5 Adverse events.
2.1
2.1. Analysis
Comparison 2 Intravenous + oral steroid versus oral steroid, Outcome 1 Complete remission.
2.2
2.2. Analysis
Comparison 2 Intravenous + oral steroid versus oral steroid, Outcome 2 Sustained remission during follow‐up.
2.3
2.3. Analysis
Comparison 2 Intravenous + oral steroid versus oral steroid, Outcome 3 All‐cause mortality.
2.4
2.4. Analysis
Comparison 2 Intravenous + oral steroid versus oral steroid, Outcome 4 Adverse events.
2.5
2.5. Analysis
Comparison 2 Intravenous + oral steroid versus oral steroid, Outcome 5 Relapse.
3.1
3.1. Analysis
Comparison 3 Intravenous steroid versus oral steroid, Outcome 1 Complete remission.
3.2
3.2. Analysis
Comparison 3 Intravenous steroid versus oral steroid, Outcome 2 Time to complete remission (days).
See this image and copyright information in PMC

References

References to studies included in this review

Coggins 1985 {published data only}
    1. Coggins CH. Adult minimal change nephropathy: experience of the collaborative study of glomerular disease. Transactions of the American Clinical & Climatological Asoociation 1985;97:18‐26. [MEDLINE: ] - PMC - PubMed
Imbasciati 1985 {published data only}
    1. Imbasciati E, Gusmano R, Edefonti A, Zucchelli P, Pozzi C, Grassi C, et al. Controlled trial of methylprednisolone pulses and low dose oral prednisone for the minimal change nephrotic syndrome. British Medical Journal Clinical Research Ed 1985;291(6505):1305‐8. [MEDLINE: ] - PMC - PubMed
Yeung 1983 {published data only}
    1. Yeung CK, Wong KL, Ng WL. Intravenous methylprednisolone pulse therapy in minimal change nephrotic syndrome. Australian & New Zealand Journal of Medicine 1983;13(4):349‐51. [MEDLINE: ] - PubMed

References to studies excluded from this review

Abaigar 1993 {published data only}
    1. Abaigar LP, Torres G, Vazquez A, Toro R, Santos J, Carrasco ML, et al. Influence of protein contents of the diet and angiotensin converting inhibitors in the adult nephrotic syndrome. Randomized and crossed, prospective study. Nefrologia 1993;13(Suppl 5):87‐93. [EMBASE: 1994008853]
Arora 2002 {published data only}
    1. Arora A, Ahlawat RS, Arora S, Mandel AK. Randomised controlled study of enalapril in steroid resistant nephrotic syndrome. Indian Journal of Nephrology 2002;12(3):http://www.ijnephrol.com/july_sep02/articleq13.html. [CENTRAL: CN‐00460300]
Bagga 1997 {published data only}
    1. Bagga A, Ekka BK, Srivastava RN. Single versus divided dose prednisolone therapy for relapses of nephrotic syndrome (NS) [abstract]. Nephrology Dialysis Transplantation 1997;12(9):A113. [CENTRAL: CN‐00261391] - PubMed
Bagga 1999 {published data only}
    1. Bagga A, Hari P, Srivastava RN. Long (lp) versus standard (sp) initial prednisolone treatment for nephrotic syndrome (ns) [abstract]. Nephrology, Urology, Transplantation Society of SAARC, Sri Lanka. 1999:158. [CENTRAL: CN‐00460325]
    1. Bagga A, Hari P, Srivastava RN. Prolonged versus standard prednisolone therapy for initial episode of nephrotic syndrome. Pediatric Nephrology 1999;13(9):824‐7. [MEDLINE: ] - PubMed
Bargman 1999 {published data only}
    1. Bargman JM. Management of minimal lesion glomerulonephritis: Evidence‐based recommendations. Kidney International ‐ Supplement 1999;55:S3‐16. [MEDLINE: ] - PubMed
Beige 2003 {published data only}
    1. Beige J, Moosmayer I, Liefeldt L, Neumayer HH, Zidek W, Peters H. Effective and safe treatment of primary nephrotic syndrome with tacrolimus (FK 506) [abstract]. Nephrology Dialysis Transplantation 2003;18(Suppl 4):65. [CENTRAL: CN‐00444378]
Black 1970 {published data only}
    1. Black DA, Rose G, Brewer DB. Controlled trial of prednisone in adult patients with the nephrotic syndrome. British Medical Journal 1970;3(5720):421‐6. [MEDLINE: ] - PMC - PubMed
Broyer 1995 {published data only}
    1. Broyer M, Terzi F, Gagnadoux MF, Guest G, Niaudet P. A randomised double blind study of deflazacort (d) versus prednisone (p) in the treatment of idiopathic nephrotic syndrome (ins) [abstract]. Journal of the American Society of Nephrology 1995;6(3):414. [CENTRAL: CN‐00483349]
Choi 2002 {published data only}
    1. Choi MJ, Eustace JA, Gimenez LF, Atta MG, Scheel PJ, Sothinathan R, et al. Mycophenolate mofetil treatment for primary glomerular diseases. Kidney International 2002;61(3):1098‐114. [MEDLINE: ] - PubMed
Cole 1994 {published data only}
    1. Cole B. Cyclosporine for nephrotic syndrome‐‐isn't it time for a collaborative trial?. Journal of the American Society of Nephrology 1994;5(4):1047‐8. [MEDLINE: ] - PubMed
Deighan 2001 {published data only}
    1. Deighan CJ, Caslake MJ, McConnell M, Boulton‐Jones JM, Packard CJ. Comparative effects of cerivastatin and fenofibrate on the atherogenic lipoprotein phenotype in proteinuric renal disease. Journal of the American Society of Nephrology 2001;12(2):341‐8. [MEDLINE: ] - PubMed
Dilek 1999 {published data only}
    1. Dilek K, Yavus M, Usta M, Ersoy A, Ilcol YO, Gullulu M, et al. The comparison of antiproteinuric effects of angiotensin converting enzyme inhibitor enalapril and angiotensin ii receptor antagonist losartan in nephrotic syndrome cases [abstract]. Nephrology Dialysis Transplantation 1999;14(9):A88. [CENTRAL: CN‐00483748]
Don 1989 {published data only}
    1. Don BR, Wada L, Kaysen GA, Schambelan M. Effect of dietary protein restriction and angiotensin converting enzyme inhibition on protein metabolism in the nephrotic syndrome. Kidney International ‐ Supplement 1989;27:S163‐7. [MEDLINE: ] - PubMed
El‐Reshaid 1995 {published data only}
    1. El‐Reshaid K, Amer E, Madda JP, Kapoor M. Long‐term cyclosporin A treatment in adults with refractory nephrotic syndrome. Renal Failure 1995;17(6):695‐703. [MEDLINE: ] - PubMed
Gentile 1993 {published data only}
    1. Gentile MG, Fellin G, Cofano F, Delle FA, Manna G, Ciceri R, et al. Treatment of proteinuric patients with a vegetarian soy diet and fish oil. Clinical Nephrology 1993;40(6):315‐20. [MEDLINE: ] - PubMed
Groggel 1989 {published data only}
    1. Groggel GC, Cheung AK, Ellis‐Benigni K, Wilson DE. Treatment of nephrotic hyperlipoproteinemia with gemfibrozil. Kidney International 1989;36(2):266‐71. [MEDLINE: ] - PubMed
Gulati 1973 {published data only}
    1. Gulati PD, Bazaz MG, Vaishnava H. A double‐blind trial of "alternate‐day" steroid therapy in adult nephrotics ‐ a preliminary report. Journal of the Association of Physicians of India 1970;18(12):963‐73. [MEDLINE: ] - PubMed
    1. Gulati PD, Malik GB, Vaishnava H. Alternate‐day steroid therapy in adult nephrotics. Journal of Medicine 1973;4(5):266‐75. [MEDLINE: ] - PubMed
Ishikawa 1982 {published data only}
    1. Ishikawa H, Honjo A, Hayashi M, Hamaguchi T, Morita T, Shindo T, et al. Effects of dipyridamole on proteinuria in chronic glomerulonephritis and the nephrotic syndrome. Arzneimittel‐Forschung 1982;32(3):301‐9. [MEDLINE: ] - PubMed
    1. Ishikawa H, Honjo A, Hayashi M, Hamaguchi T, Morita T, Tesutani T, et al. The therapeutical effect of dipyridamole on chronic glomerulonephritis and nephrotic syndrome in large dose administration‐‐the study in a double blind group comparison method. Nippon Jinzo Gakkai Shi. Japanese Journal of Nephrology 1979;21(2):135‐55. [MEDLINE: ] - PubMed
Koike 2002 {published data only}
    1. Koike M, Honda K, Tsukada M, Itabashi M, Suzuki K, Uchida K, et al. Low‐dose cyclosporin therapy combined with prednisolone for relapsing minimal change nephrotic syndrome in adults. Nippon Jinzo Gakkai Shi. Japanese Journal of Nephrology 2002;44(5):447‐52. [MEDLINE: ] - PubMed
Kumar 2004 {published data only}
    1. Kumar NS, Mishra RN, Singh AK, Prakash J. Effect of Ace inhibitor and calcium channel blocker on proteinuria in subjects with steroid resistant idiopathic nephrotic syndrome [abstract]. Indian Journal of Nephrology 2001;11(3):110‐1. [CENTRAL: CN‐00461120]
    1. Kumar NS, Singh AK, Mishra SN, Prakash J. Comparative study of angiotensin converting enzyme inhibitor and calcium channel blocker in the treatment of steroid‐resistant idiopathic nephrotic syndrome. Journal of the Association of Physicians of India 2004;52:454‐8. [MEDLINE: ] - PubMed
Lee 1995 {published data only}
    1. Lee HY, Kim HS, Kang CM, Kim SG, Kim MJ. The efficacy of cyclosporine A in adult nephrotic syndrome with minimal change disease and focal‐segmental glomerulosclerosis: a multicenter study in Korea. Clinical Nephrology 1995;43(6):375‐81. [MEDLINE: ] - PubMed
Leisti 1978 {published data only}
    1. Leisti S, Koskimies O, Perheentupa J, Vilska J, Hallman N. Idiopathic nephrotic syndrome: prevention of early relapse. British Medical Journal 1978; Vol. 1, issue 6117:892. [MEDLINE: ] - PMC - PubMed
Mansy 1989 {published data only}
    1. Mansy H, Goodship TH, Tapson JS, Hartley GH, Keavey P, Wilkinson R. Effect of a high protein diet in patients with the nephrotic syndrome. Clinical Science 1989;77(4):445‐51. [MEDLINE: ] - PubMed
Martins 1994 {published data only}
    1. Martins PM, Nogueira AC, Reimao PJ, Correia AM, Vicente O, Rodrigues MC, et al. Long‐term effect of lovastatin on lipoprotein profile in patients with primary nephrotic syndrome. Clinical Nephrology 1994;41(5):277‐83. [MEDLINE: ] - PubMed
Matl 1997 {published data only}
    1. Matl I, Matousovic K, Herout V, Konecny K, Kovac A, Rychlik I, et al. A controlled clinical trial of Consupren versus cyclophosphamide in chronic glomerulonephritis. Casopis Lekaru Ceskych 1997;136(4):120‐123. [MEDLINE: ] - PubMed
    1. Matl I, Matousovic K, Herout V, Konency K, Kovac A, Rychlik I, et al. A controlled clinical study of Consupren versus Cyclophosphamide in chronic glomerulonephritis. I. Efficacy of therapy. Casopis Lekaru Ceskych 1997;136(4):120‐3. [EMBASE: 1997068194] - PubMed
Matsubara 2002 {published data only}
    1. Matsubara M, Nogae S, Ito S. Novel trial for the treatment of steroid dependency in minimal change disease: Combined therapy of camostat mesilate and glycyrrhizin. Nephron 2002;90(3):357‐60. [MEDLINE: ] - PubMed
Matsumoto 2004 {published data only}
    1. Matsumoto H, Nakao T, Okada T, Nagaoka Y, Takeguchi F, Tomaru R, et al. Favorable outcome of low‐dose cyclosporine after pulse methylprednisolone in Japanese adult minimal‐change nephrotic syndrome. Internal Medicine 2004;43(8):668‐73. [MEDLINE: ] - PubMed
Matzkies 1999 {published data only}
    1. Matzkies FH, Bahner U, Teschner M, Hohage H, Heidland A, Schaefer RM. Efficiency of 1‐year treatment with fluvastatin in hyperlipidemic patients with nephrotic syndrome. American Journal of Nephrology 1999;19(4):492‐4. [MEDLINE: ] - PubMed
Meyrier 1988 {published data only}
    1. Meyrier A, Condamin MC, Simon P. Treatment with cyclosporine of adult idiopathic nephrotic syndrome resistant to corticosteroid and other immunosuppressants. Transplantation Proceedings 1988;20(3 Suppl 4):259‐61. [EMBASE: 1988158714] - PubMed
Meyrier 1991 {published data only}
    1. Meyrier A, Condamin MC, Broneer D. Treatment of adult idiopathic nephrotic syndrome with cyclosporin A: minimal‐change disease and focal‐segmental glomerulosclerosis. Collaborative Group of the French Society of Nephrology. Clinical Nephrology 1991;35(1):S37‐42. [MEDLINE: ] - PubMed
Meyrier 1994 {published data only}
    1. Meyrier A, Noel L‐H, Auriche P, Callard P. Long‐term renal tolerance of cyclosporin A treatment in adult idiopathic nephrotic syndrome. Collaborative Group of the Societe de Nephrologie. Kidney International 1994;45(5):1446‐56. [MEDLINE: ] - PubMed
Meyrier 1996 {published data only}
    1. Meyrier A. Use of cyclosporine A in the treatment of refractory nephrotic syndrome in adults. Renal Failure 1996;18(5):775‐84. [MEDLINE: ] - PubMed
Mocan 1997 {published data only}
    1. Mocan H, Mocan MZ. The effect of high dose methylprednisolone therapy in patients with minimal change nephrotic syndrome [abstract]. Nephrology Dialysis Transplantation 1997;12(9):A74. [CENTRAL: CN‐00261380]
Naigui 1997 {published data only}
    1. Naigui X, Jian X, Jing H. A clinical study on low dose cyclosporin a with diltiazem in the treatment of primary nephrotic syndrome [abstract]. Nephrology 1997;3(Suppl 1):S125. [CENTRAL: CN‐00461383]
Ni 2003 {published data only}
    1. Ni ZH, Qian JQ, Lin AW, Mu S, Zhu ML, Fang W. A controlled, prospective study of efficacy of leflunomide in patients with nephrotic syndrome [abstract]. Journal of the American Society of Nephrology 2003;14(Nov):524A. [CENTRAL: CN‐00520368]
Niaudet 1994 {published data only}
    1. Niaudet P, Habib R. Cyclosporine in the treatment of idiopathic nephrosis. Journal of the American Society of Nephrology 1994;5(4):1049‐56. [MEDLINE: ] - PubMed
Olbricht 1999 {published data only}
    1. Olbricht CJ, Wanner C, Thiery J, Basten A. Simvastatin in nephrotic syndrome. Simvastatin in Nephrotic Syndrome Study Group. Kidney International ‐ Supplement 1999;71:S113‐6. [MEDLINE: ] - PubMed
Pecoraro 2003 {published data only}
    1. Pecoraro C, Caropreso MR, Passaro G, Fereto AV, Malgieri G. Therapy of first episode of steroid responsive nephrotic syndrome: a randomised controlled trial [abstract]. Nephrology Dialysis Transplantation 2003;18(Suppl 4):63. [CENTRAL: CN‐00447140]
Piccoli 1993 {published data only}
    1. Piccoli A, Gastaldon F, Pillon L, Mussap M, Faggian D, Plebani M, et al. Bioequivalence of deflazacort and prednisone in the treatment of idiopathic nephrotic syndrome. A pilot study. Current Therapeutic Research ‐ Clinical and Experimental 1993;54(5):588‐97. [EMBASE: 1993345953]
Pirisi 1998 {published data only}
    1. Pirisi M, Faedda R, Satta A, Bartoli E. Immunosuppressive treatment for idiopathic syndrome with corticosteroids and cyclophosphamide. Factors associated with a favorable outcome. Clinical Drug Investigation 1998;16(3):211‐8. [EMBASE: 1998351604] - PubMed
Ponticelli 1993 {published data only}
    1. Ponticelli C. A multicenter controlled prospective trial with cyclosporine vs cyclophosphamide in frequent relapsers and steroid dependent patients with idiopathic nephrotic syndrome. Journal of Nephrology 1989;2(2):147‐51. [EMBASE: 1991014828]
    1. Ponticelli C. Ciclosporin in the treatment of idiopathic nephrotic syndrome [abstract]. 10th Asian Colloquium in Nephrology; 1994 Dec 2‐6; Karachi (Pakistan). 1994:116. [CENTRAL: CN‐00461528]
    1. Ponticelli C, Edefonti A, Ghio L, Rizzoni G, Rinaldi S, Gusmano R, et al. Cyclosporin versus cyclophosphamide for patients with steroid‐dependent and frequently relapsing idiopathic nephrotic syndrome: a multicentre randomized controlled trial. Nephrology Dialysis Transplantation 1993;8(12):1326‐32. [MEDLINE: ] - PubMed
Ponticelli 1993A {published data only}
    1. Ponticelli C, Rizzoni G, Edefonti A, Altieri P, Rivolta E, Rinaldi S, et al. A randomized trial of cyclosporine in steroid resistant idiopathic nephrotic syndrome. Kidney International 1993;43(6):1377‐84. [MEDLINE: ] - PubMed
Rabelink 1988 {published data only}
    1. Rabelink AJ, Hene RJ, Erkelens DW, Joles JA, Koomans HA. Effects of simvastatin and cholestyramine on lipoprotein profile in hyperlipidaemia of nephrotic syndrome. Lancet 1988;2(8624):1335‐8. [MEDLINE: ] - PubMed
Reichert 1999 {published data only}
    1. Reichert LJ, Koene RA, Wetzels JF. Acute haemodynamic and proteinuric effects of prednisolone in patients with a nephrotic syndrome. Nephrology Dialysis Transplantation 1999;14(1):91‐7. [MEDLINE: ] - PubMed
Sharpstone 1969 {published data only}
    1. Sharpstone P, Ogg CS, Cameron JS. Nephrotic syndrome due to primary renal disease in adults: II. A controlled trial of prednisone and azathioprine. British Medical Journal 1969;2(5656):535‐9. [MEDLINE: ] - PMC - PubMed
Shibasaki 2004 {published data only}
    1. Shibasaki T, Koyama A, Hishida A, Muso E, Osawa G, Yamabe H, et al. A randomized open‐label comparative study of conventional therapy versus mizoribine onlay therapy in patients with steroid‐resistant nephrotic syndrome (postmarketing survey). Clinical & Experimental Nephrology 2004;8(2):117‐26. [MEDLINE: ] - PubMed
Spitalewitz 1993 {published data only}
    1. Spitalewitz S, Porush JG, Cattran D, Wright N. Treatment of hyperlipidemia in the nephrotic syndrome: the effects of pravastatin therapy. American Journal of Kidney Diseases 1993;22(1):143‐50. [MEDLINE: ] - PubMed
Sural 2001 {published data only}
    1. Sural S, Pahari DK, Mitra K, Bhattacharya S, Mondal S, Taraphder A. Efficacy of levamisole compared to cyclophosphamide and steroid in frequently in frequently relapsing (FR) minimal change nephrotic syndrome (MCNS) [abstract]. Journal of the American Society of Nephrology 2001;12(Program & Abstracts):126A. [CENTRAL: CN‐00447910]
Tejani 1988 {published data only}
    1. Tejani A, Gonzalez R, Rajpoot D, Sharma R, Pomrantz A. A randomized trial of cyclosporine with low‐dose prednisone compared with high‐dose prednisone in nephrotic syndrome. Transplantation Proceedings 1988;20(3 Suppl 4):262‐4. [MEDLINE: ] - PubMed
Thomas 1993 {published data only}
    1. Thomas ME, Harris KP, Ramaswamy C, Hattersley JM, Wheeler DC, Varghese Z, et al. Simvastatin therapy for hypercholesterolemic patients with nephrotic syndrome or significant proteinuria. Kidney International 1993;44(5):1124‐9. [MEDLINE: ] - PubMed
Toto 2000 {published data only}
    1. Toto RD, Grundy SM, Vega GL. Pravastatin treatment of very low density, intermediate density and low density lipoproteins in hypercholesterolemia and combined hyperlipidemia secondary to the nephrotic syndrome. American Journal of Nephrology 2000;20(1):12‐7. [MEDLINE: ] - PubMed
Uldall 1972 {published data only}
    1. Uldall PR, Feest TG, Morley AR, Tomlinson BE, Kerr DN. Cyclophosphamide therapy in adults with minimal change nephrotic syndrome. Lancet 1972;1(7763):1250‐3. [MEDLINE: ] - PubMed
Wyszynska 1988 {published data only}
    1. Wyszynska T, Ksiasek J, Uszycka‐Karcz M, Kobierska‐Szczepanska A, Morawska Z, Zoch‐Zwierz W. Evaluation of prednisolone pulse therapy in steroid‐resistant nephrotic syndrome. A multicenter collaborative study. Contributions to Nephrology 1988;67:229‐32. [MEDLINE: ] - PubMed
Ye 1993 {published data only}
    1. Ye R, Zhang D. Contrasting efficacy of two different treatment programs in adult frequently relapsing nephrotic syndrome [abstract]. Journal of the American Society of Nephrology 1993;4(Program & Abstracts). [CENTRAL: CN‐00486532]
Yoshikawa 1995 {published data only}
    1. Yoshikawa N, Tanaka R, Kitano Y, Nakamura H, Ito H. Long‐term cyclosporin in steroid‐dependent nephrotic syndrome. Contributions to Nephrology 1995;114:19‐27. [MEDLINE: ] - PubMed

Additional references

Al Khader 1979
    1. Al‐Khader AA, Lien JW, Aber GM. Cyclophosphamide alone in the treatment of adult patients with minimal change glomerulonephritis. Clinical Nephrology 1979;11(1):26‐30. [MEDLINE: ] - PubMed
Arneil 1961
    1. Arneil GC. 164 children with nephrosis. Lancet 1961;II:1103‐10. - PubMed
Begg 1996
    1. Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, et al. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA 1996;276(8):637‐9. [MEDLINE: ] - PubMed
Briggs 1998
    1. Briggs WA, Choi MJ, Scheel PJ Jr. Successful mycophenolate mofetil treatment of glomerular disease. American Journal of Kidney Diseases 1998;31(2):213‐7. [MEDLINE: ] - PubMed
Day 2002
    1. Day CJ, Cockwell P, Lipkin GW, Savage CO, Howie AJ, Adu D. Mycophenolate mofetil in the treatment of resistant idiopathic nephrotic syndrome. Nephrology Dialysis Transplantation 2002;17(11):2011‐3. [MEDLINE: ] - PubMed
Dickersin 1994
    1. Dickersin K, Scherer R, Lefebvre C. Identifying relevant studies for systematic reviews. BMJ 1994;309(6964):1286‐91. [MEDLINE: ] - PMC - PubMed
Durkan 2005
    1. Durkan A, Hodson EM, Willis NS, Craig JC. Non‐corticosteroid treatment for nephrotic syndrome in children. Cochrane Database of Systematic Reviews 2005, Issue 2. [Art. No.: CD002290. DOI: 10.1002/14651858.CD002290.pub2] - PubMed
Egger 1997
    1. Egger M, Davey‐Smith G, Schneider M, Minder C. Bias in meta‐analysis detected by a simple graphical test. BMJ 1997;315(7109):629‐34. [MEDLINE: ] - PMC - PubMed
EUVAS 2006
    1. The European Vasculitis Study Group. http://www.vasculitis.org (accessed November 2007).
Grimbert 2003
    1. Grimbert P, Audard V, Remy P, Lang P, Sahali D. Recent approaches to the pathogenesis of minimal‐change nephrotic syndrome. Nephrology Dialysis Transplantation 2003;18(2):245‐8. [MEDLINE: ] - PubMed
Haas 1995
    1. Haas M, Spargo BH, Coventry S. Increasing incidence of focal‐segmental glomerulosclerosis among adult nephropathies. American Journal of Kidney Diseases 1995;26(5):740‐50. [MEDLINE: ] - PubMed
Haas 1997
    1. Haas M, Meehan SM, Karrison TG, Spargo BH. Changing etiologies of unexplained adult nephrotic syndrome: a comparison of renal biopsy findings from 1976‐1979 and 1995‐1997. American Journal of Kidney Diseases 1997;30(5):621‐31. [MEDLINE: ] - PubMed
Higgins 2003
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ 2003;327(7414):557‐60. [MEDLINE: ] - PMC - PubMed
Hodson 2006
    1. Hodson EM, Habashy D, Craig JC. Interventions for idiopathic steroid‐resistant nephrotic syndrome in children. Cochrane Database of Systematic Reviews 2006, Issue 2. [Art. No.: CD003594. DOI: 10.1002/14651858.CD003594.pub3] - PubMed
Hodson 2007
    1. Hodson EM, Willis NS, Craig JC. Corticosteroid therapy for nephrotic syndrome in children. Cochrane Database of Systematic Reviews 2007, Issue 4. [Art. No.: CD001533. DOI: 10.1002/14651858.CD001533.pub4] - PubMed
Johnson 2003
    1. Johnson RJ, Feehally J (editors). Comprehensive clinical nephrology. 2nd Edition. Edinburgh: Mosby, Elsevier Limited, 2003.
Korbet 1996
    1. Korbet SM, Genchi RM, Borok RZ, Schwartz MM. The racial prevalence of glomerular lesions in nephrotic adults. American Journal of Kidney Diseases 1996;27(5):647‐51. [MEDLINE: ] - PubMed
Lefebvre 1996
    1. Lefebvre C, McDonald S. Development of a sensitive search strategy for reports of randomized controlled trials in EMBASE. Fourth International Cochrane Colloquium; 1996 Oct 20‐24; Adelaide (Australia). 1996.
Mak 1996
    1. Mak SK, Short CD, Mallick NP. Long‐term outcome of adult‐onset minimal‐change nephropathy. Nephrology Dialysis Transplantation 1996;11(11):2192‐201. [MEDLINE: ] - PubMed
Master List 2007
    1. United States Cochrane Center. Master list of journals being searched. http://apps1.jhsph.edu/cochrane/masterlist.asp (accessed May 2007).
Mogyorosi 2002
    1. Mogyorosi A, Lippman HR, Feldman GM. Successful treatment of steroid‐resistant minimal change disease with mycophenolate mofetil. American Journal of Nephrology 2002;22(5‐6):569‐72. [MEDLINE: ] - PubMed
Nakayama 2002
    1. Nakayama M, Katafuchi R, Yanase T, Ikeda K, Tanaka H, Fuijimi S. Steroid responsiveness and frequency of relapse in adult‐onset minimal change nephrotic syndrome. American Journal of Kidney Diseases 2002;39(3):503‐12. [MEDLINE: ] - PubMed
Nolasco 1986
    1. Nolasco F, Cameron JS, Heywood EF, Hicks J, Ogg C, Williams DG. Adult‐onset minimal change nephrotic syndrome: a long‐term follow‐up. Kidney International 1986;29(6):1215‐23. [MEDLINE: ] - PubMed
Patel 2005
    1. Patel P, Pal S, Ashley C, Sweny P, Burns A. Combination therapy with sirolimus (rapamycin) and tacrolimus (FK‐506) in treatment of refractory minimal change nephropathy, a clinical case report. Nephrology Dialysis Transplantation 2005;20(5):985‐7. [MEDLINE: ] - PubMed
Schweda 1997
    1. Schweda F, Liebl R, Riegger GA, Kramer BK. Tacrolimus treatment for steroid‐ and cyclosporin‐resistant minimal‐change nephrotic syndrome. Nephrology Dialysis Transplantation 1997;12(11):2433‐5. [MEDLINE: ] - PubMed
Tse 2003
    1. Tse KC, Lam MF, Yip PS, Li FK, Choy BY, Lai KN, et al. Idiopathic minimal change nephrotic syndrome in older adults: steroid responsiveness and pattern of relapses. Nephrology Dialysis Transplantation 2003;18(7):1316‐20. [MEDLINE: ] - PubMed
Westhoff 2006
    1. Westhoff TH, Schmidt S, Zidek W, Beige J, Giet M. Tacrolimus in steroid‐resistant and steroid‐dependent nephrotic syndrome. Clinical Nephrology 2006;65(6):393‐400. [MEDLINE: ] - PubMed
Woo 2001
    1. Woo KT, Chew ST, Vathsala A, Chiang GS. Case reports of low dose cyclosporine. A therapy in adult minimal change nephrotic syndrome. Annals of the Academy of Medicine, Singapore 2001;30(4):430‐5. [MEDLINE: ] - PubMed

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