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NDT Plus Advance Access originally published online on June 12, 2009
NDT Plus 2009 2(5):368-369; doi:10.1093/ndtplus/sfp064
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

The combined use of sirolimus and cyclosporin in the management of refractory minimal change nephropathy: ‘a novel use of sirolimus’

Rachel Davison and Sean Fenwick

Sunderland Royal Hospital, Kayll Road, Sunderland, SR4 7TP, UK

Correspondence: Correspondence and offprint requests to: Sean Fenwick; E-mail: Sean.Fenwick{at}chs.northy.nhs.uk


  Abstract

Minimal change nephropathy (MCN) accounts for around 25% of adults presenting with a nephrotic syndrome. Although most patients respond to corticosteroid therapy, a significant number relapse frequently and may present a real therapeutic difficulty. We present a case of apparently refractory relapsing MCN that was successfully treated with a combination of sirolimus and cyclosporin, resulting in the longest period of steroid free remission that the patient has ever experienced. To our knowledge, this is the first documented use of this combination in this manner.

Key Words: cyclosporine • minimal change • nephrotic syndrome • sirolimus

Received for publication May 15, 2009. Accepted for publication May 19, 2009.


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