Focal Segmental Glomerulosclerosis Medication

Updated: Dec 07, 2020
  • Author: Sreepada TK Rao, MD, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to preserve renal function, to reduce morbidity, and to prevent complications. Medications used include angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), diuretics, and corticosteroids, with agents such as cyclophosphamide considered in steroid-resistant cases.

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Immunosuppressants

Class Summary

Current approach calls for initiating therapy with prednisone. In patients whose conditions are refractory to 2-3 mo of prednisone therapy, recommendations include reducing the steroid dose and adding cyclophosphamide. A prospective study indicated that 5-10 mg/kg/d of cyclosporine may be beneficial in patients unresponsive to prednisone and cyclophosphamide. Mycophenolate mofetil may be another alternative agent in patients with renal insufficiency in whom cyclosporine cannot be used. These powerful immunosuppressive agents need careful monitoring and are best used by specialists in the field.

Prednisone (Deltasone, Orasone, Meticorten)

Immunosuppressant for treatment of autoimmune disorders. May decrease inflammation by reversing increased capillary permeability and suppressing PMN activity. Stabilizes lysosomal membranes and suppresses lymphocytes and antibody production.

Cyclophosphamide (Cytoxan, Neosar)

Chemically related to nitrogen mustards. As an alkylating agent, the mechanism of action of the active metabolites may involve cross-linking of DNA, which may interfere with growth of normal and neoplastic cells.

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