FK 506 in the management of transplant-related nephrotic syndrome and steroid-resistant nephrotic syndrome.

Abstract

Nephrotic syndrome is a broad group of disorders with diverse etiologies. In common, all have proteinuria, edema, hypercholesterolemia, and hypoalbuminemia. Steroids have proven effective in some histologic groups, but many are resistant to steroids and progress to end-stage renal disease. Transplant glomerulopathy and chronic rejection also contribute heavily to renal transplant-related nephrotic syndrome. Previous studies with cyclosporine (CyA)1,2 and FK 5063 suggest that the clinical manifestations of nephrotic syndrome may be controlled with these agents, in native kidneys and in renal allografts. FK 506 is a potent macrolide immunosuppressant agent, which has proven effective in transplantation of the liver, kidney, and heart.4–6 We have previously reported successful treatment of two patients with steroid-resistant nephrotic syndrome with FK 506.3 We report, herein, our preliminary experience treating steroid-resistant nephrotic syndrome and nephrotic syndrome after transplantation with FK 506.