Using Montelukast as an Add-on Treatment in Nephrotic Syndrome of Pediatrics: A Randomized Clinical Trial Study

Abstract

Background: Montelukast, as a non-steroidal anti-inflammatory drug, could reduce inflammation in nephrotic syndrome (NS). This study aimed to evaluate the therapeutic effect of montelukast as adjunctive therapy in pediatric NS. Methods: This clinical trial study was conducted on patients with NS. The patients were assigned into two equal groups (N = 25 in each) of intervention (steroid + montelukast) and control and treated for one month. One month later, in the follow-up stage, their proteinuria was measured. The results before and after treatment were statistically analyzed by SPSS software version 21, and the final report of the project was presented. Results: The age of participants in the intervention and control groups was 7.26 ± 4.23 and 6.79 ± 3.91 years, respectively (P = 0.68), and there were 10 female participants in both groups (P = 1.0). Albumin levels in 96% of the control group and 76% of the intervention group were 1.5 - 2.5 μg/dL (P = 0.037). Also, 48% of participants in the control group were corticosteroid dependent, and 60% of participants in the intervention group responded to corticosteroids (P = 0.194). The severity of nephrotic syndrome was moderate in 60% of participants in the control group and mild in 60% of participants in the intervention group (P = 0.138). Conclusions: The results of this study showed that recovery rate was higher in the intervention group, but the difference was not statistically significant.

The renoprotective potential of montelukast: a scoping review

“…Studies examining montelukast effect on humans with minimal change nephrotic syndrome (MCNS) 45 , steroid-sensitive nephrotic syndrome (SSNS) 42 , 46 , nephrotic syndrome 47 , and pyelonephritis 48 had similar results and showed montelukast having great effects on decreasing corticosteroid dosage in treatment 45 , preventing relapse rate in children with SSNS 42 , a significant decrease in serum creatinine, and a significant increase in diastolic blood pressure and protein/creatinine ratio 46 , increasing the improvement rate of clinical manifestations in children with pyelonephritis 49 , with one exception of montelukast increasing the recovery rate but not statistically significant 48 .…”