Use of Cyclosporine Therapy in Steroid Resistant Nephrotic Syndrome (SRNS): A Review

Shah, Syed Raza; Altaf, Areeba; Arshad, Mohammad Hussham; Mari, Anum; Noorani, Sahir; Saeed, Eraj; Mevawalla, Areesh Amir; Haq, Zaiyn Ul; Faquih, Muhammad Ehsan

doi:10.5539/gjhs.v8n4p136

Cited by 14 publications

(8 citation statements)

References 30 publications

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“…However, long-term side effects, such as nephrotoxicity [101] and hypertension [102], represent a current concern. On the other hand, CNIs were found to be safe in children diagnosed with glomerulopathy, which cannot be treated by steroids [103], another class of immunosuppressant drugs.…”

Section: Presentation Classification and Usementioning

confidence: 99%

The Advantages of Polymeric Hydrogels in Calcineurin Inhibitor Delivery

2020

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In recent years, polymeric hydrogels (PolyHy) have been extensively explored for their applications in biomedicine as biosensors, in tissue engineering, diagnostic processes, and drug release. The physical and chemical properties of PolyHy indicate their potential use in regulating drug delivery. Calcineurin inhibitors, particularly cyclosporine (CsA) and tacrolimus (TAC), are two important immunosuppressor drugs prescribed upon solid organ transplants. Although these drugs have been used since the 1970s to significantly increase the survival of transplanted organs, there are concerns regarding their undesirable side effects, primarily due to their highly variable concentrations. In fact, calcineurin inhibitors lead to acute and chronic toxicities that primarily cause adverse effects such as hypertension and nephrotoxicity. It is suggested from the evidence that the encapsulation of calcineurin inhibitors into PolyHy based on polysaccharides, specifically alginate (Alg), offers effective drug delivery with a stable immunosuppressive response at the in vitro and in vivo levels. This not only may reduce the adverse effects but also would improve the adherence of the patients by the effective preservation of drug concentrations in the therapeutic ranges.

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Section: Presentation Classification and Usementioning

confidence: 99%

The Advantages of Polymeric Hydrogels in Calcineurin Inhibitor Delivery

2020

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“…Furthermore, the recurrence rate with catheter ablation was far lower as compared to antiarrhythmic drug therapy alone [51,52]. Overall, radiofrequency catheter ablation is a treatment method that has been shown to enhance the patient’s quality of life and also improves ventricle function in a large portion of patients [53,54]. Therefore, this in the long-term is very effective in the management of AFIB/AFLUT.…”

Section: Management and Treatmentmentioning

confidence: 99%

Management of atrial fibrillation-flutter: uptodate guideline paper on the current evidence

Shah

Luu

Calestino

et al. 2018

Journal of Community Hospital Internal Medicine Perspectives

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The term ‘flutter’ and ‘fibrillation’ were first coined to differentiate the differences between fast, regular contractions in Atrial Flutter (AFLUT) with irregular, vermiform contractions of Atrial Fibrillation (AFIB). Management of these two diseases has been a challenge for physicians. Rate control (along with rhythm control) is the first line of management for symptomatic AFIB/AFLUT with Rapid Ventricular Rate (RVR). In some situations, atrial rhythms may not be well controlled by these anti-arrhythmic drugs, making cardioversion to sinus rhythm necessary. Anti-coagulation therapy in both the disease population is essential. Catheter ablation is an effective treatment option in certain patients that have AFIB/AFLUT refractory to medical management. Newer techniques like left atrial appendage (LAA) has been developed and is a highly attractive concept for the future in the management of AFIB/AFLUT. Newer novel drugs targeting specific ion channels are approaching the stages of clinical investigation. However, while advances in technologies have helped elucidate many aspects of these diseases, many mysteries still remain. This literature review serves as one of the guideline papers for current up-to-date management on both AFIB and AFLUT.

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“…The remission rate with this regimen is acceptable, but many patients experience recurrence. Complications associated with treatment include infection, 3 renal dysfunction, 4 and other adverse events that can lead to repeated hospitalization and even death. Kidney diseases have been treated with traditional Chinese medicine (TCM) for centuries in many countries and much clinical experience has accumulated 5 , 6 .…”

Section: Introductionmentioning

confidence: 99%

Effects of Jian Pi Qu Shi Formula on intestinal bacterial flora in patients with idiopathic membranous nephropathy: A prospective randomized controlled trial

Lang

Wang

et al. 2020

Chronic Diseases and Translational Medicine

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BackgroundThe incidence of idiopathic membranous nephropathy (IMN) has recently increased remarkably. Immune dysfunction caused by disordered intestinal flora might be an important factor affecting IMN. The Jian Pi Qu Shi Formula (JPQSF) shows promise in treating IMN. Here, we sequenced 16S rRNA genes to compare intestinal flora between patients with IMN and healthy persons. We also conducted a randomized controlled clinical trial to further compare the intestinal flora of patients with IMN treated with traditional Chinese medicine (TCM) and western medicine (WM).MethodsAmong 40 patients with IMN treated at Department of Nephrology in Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine between July 2016 and December 2018, we compared 30 of them with 10 healthy persons (controls). The IMN group was randomly assigned to receive JPQSF (TCM) or immunosuppressant WM therapy in (n = 15 per group) for 6 months. Intestinal microbiota diversity was analyzed using alpha diversity and beta diversity. Intestinal flora that significantly differed between the groups was analyzed using MetaStat. The effects and safety of the therapies were determined based on the values for plasma albumin, 24‐h urine protein excretion, serum creatinine, urea nitrogen, estimate glomerular filtration rate (eGFR), complete blood count, and liver enzymes. All data were statistically analyzed using Statistical Package for the Social Sciences (SPSS) 20.0 statistical software.ResultsBaseline characteristics did not significantly differ between the IMN and healthy groups, or the TCM and WM groups. After six months of treatment, 24‐h urinary protein significantly declined in the TCM and WM groups (before and after treatment: 3.24 ± 1.74 vs. 1.73 ± 1.85 g, P < 0.05 and 3.94 ± 1.05 vs. 1.91 ± 1.18 g, P < 0.05, respectively). Plasma albumin was significantly increased in the TCM group (before vs. after treatment: 32.44 ± 9.04 vs. 39.99 ± 7.03 g/L, P < 0.05), but did not significantly change in the WM group (31.55 ± 4.23 vs. 34.83 ± 9.14 g/L, P > 0.05). Values for urea nitrogen, serum creatinine, and eGFR did not significantly change in either group. The alpha diversity index for intestinal flora differed between the IMN and healthy groups, and the TCM and WM groups. Comparisons of multiple samples (beta diversity) revealed differences in intestinal flora between the IMN and healthy groups, and the TCM and WM groups. The Metastat analysis findings showed that the main genera that differed between the IMN group before treatment and the healthy group were Christensenellaceae_R‐7_group, Bifidobacterium (77), Dorea, Escherichia‐Shigella, Parabacteroides, Bifidobacterium, and Coprococcus_3. After TCM therapy, the main differential genera were Butyricimonas, Bacteroides, Alistipes, and Lachnospira, and after WM therapy, these were Ruminococcus_2, Lachnospiraceae_ND3007_group, Lachnospira, Bifidobacterium, Alistipes, and [Eubacterium]_ventriosum_group.ConclusionPatients with IMN might have disordered intestinal flora, and JPQSF can regulate intestinal flora in patients with IMN.

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Use of Cyclosporine Therapy in Steroid Resistant Nephrotic Syndrome (SRNS): A Review

Cited by 14 publications

References 30 publications

The Advantages of Polymeric Hydrogels in Calcineurin Inhibitor Delivery

The Advantages of Polymeric Hydrogels in Calcineurin Inhibitor Delivery

Management of atrial fibrillation-flutter: uptodate guideline paper on the current evidence

Effects of Jian Pi Qu Shi Formula on intestinal bacterial flora in patients with idiopathic membranous nephropathy: A prospective randomized controlled trial

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