Clinical Profile and Therapeutic Level of Tacrolimus in Children withSteroid Resistant Nephrotic Syndrome-A Single Centre Retrospective Study

Abstract

Background: Nephrotic Syndrome is a chronic kidney disease in children.Majority of the children usually respond to standard steroids treatment and achieve complete remission of proteinuria but 10-15% of these patients do not respond to steroid. This condition is categorized as steroid resistant nephrotic syndrome (SRNS) and treated with Calcineurin inhibitors. The Tacrolimus is one of the important Calcineurin inhibitor prescribed for thetreatment of SRNS. The aim of this study is tostudy Clinical profile and therapeutic level of Tacrolimus in Children with Steroid Resistant Nephrotic Syndrome.

Method: A retrospective study of follow up patients referred to Drug Assay Lab was done. Therapeutic drug monitoring of tacrolimus was done for the SRNS patients from January, 2021 to April, 2021.The clinical profile 55 children with steroid resistant nephrotic syndrome were assessed. Data was evaluated on the basis of laboratory report of tacrolimus and hospital patient’s card of these patients.

Results: 55 patients were studied. Mean age at onset of Nephrotic syndrome was 5.45±3.79. Gender distribution ration was 2.43:1. Kidney Biopsy results showed thatmost common histological diagnosis was minimal change disease (47.27%) followed by Focal Segmental Glomerulosclerosis (34.54%).Themean trough concentration of tacrolimus at follow up visit after one year was found 6.41 ng/mL and 61.81% achieved a remission and 30.90% patients showed partial remission.

Conclusion:61.81% patients achieved a complete remission and 30.90% patients showed partial remission.Clinical profile and trough level of tacrolimus of children showed a better treatment outcome with tacrolimus therapy.