Steroid-refractory nephrotic syndrome

Nephrotic syndrome that fails to respond to a standard glucocorticoid course. Most often focal segmental glomerulosclerosis or membranous nephropathy on biopsy. Requires steroid-sparing immunosuppression.

ICD-10 N041 drug

Also known as: Steroid-resistant nephrotic syndrome

Drugs used for this condition

BCiclosporinSecond line · Immunosuppressants. Calcineurin inhibitorsIn steroid-refractory nephrotic syndrome, including focal segmental glomerulosclerosis and membranous nephropathy, cyclosporine induces remission in 50–60% of patients. Duration is 12–24 months with gradual withdrawal once stable remission is achieved. Target concentrations are lower than in transplantation (100–175 ng/mL).

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit