Concomitant administration of cyclosporine and ketoconazole in idiopathic nephrotic syndrome

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
Amr El-HusseiniMohamed A Sobh

Abstract

The deliberate use of ketoconazole to reduce the need for cyclosporine (CsA) is not new, but it is particularly relevant because of the high cost of CsA. Many studies have documented this benefit in renal and cardiac transplants, but this co-administration has not been reported in patients with nephrotic syndrome. This retrospective study included 207 nephrotic patients who were steroid resistant, dependent or frequent relapsers and received CsA therapy. Among these patients 153 received daily ketoconazole therapy in a dose of 50 mg with concomitant decrease of one-third of the CsA dose while 54 patients received CsA alone. The majority of our cases were children (179 were below 18 years) and male to female ratio was 1.7:1. The great majority of the study population received the drugs for 1-2 years. Patients who received CsA and ketoconazole were comparable with those who received CsA alone regarding age, sex, duration of renal disease, renal pathology, severity of nephrotic syndrome, renal function, hepatic function and steroid response. Co-administration of ketoconazole significantly reduced mean doses of CsA by 37% after 1 month and 47% at 1 year with overall net cost savings of 37%. Hepatic functions remained within the nor...Continue Reading

References

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Sep 7, 1995·The New England Journal of Medicine·A KeoghA Kaan
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Citations

Jun 22, 2005·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Elisabeth M HodsonNarelle S Willis
Mar 9, 2010·The Tohoku Journal of Experimental Medicine·Koichi SuzukiHiroshi Tanaka
Dec 18, 2013·Indian Journal of Nephrology·A IyengarM Bitzan
Oct 6, 2005·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Amr El-HusseiniMohamed Sobh
Oct 30, 2013·The Cochrane Database of Systematic Reviews·Nanthiya PravitsitthikulJonathan C Craig

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