nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-1011Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESТакролимус в лечении стероид-резистентного нефротического синдрома у детей (Предварительные результаты одноцентрового исследования)ПриходинаЛ. С.PrikhodinaL. S.prikhodina@rambler.ruТурпиткоО. Ю.TurpitkoO. Yu.noemail@neicon.ruДлинВ. В.DlinV. V.noemail@neicon.ruИгнатоваМ. С.IgnatovaM. S.noemail@neicon.ruФГУ «МНИИ педиатрии и детской хирургии Минздравсоцразвития», МоскваРоссияRussian Federal State Organisation “Moscow research institute of pediatry and children surgery” of the Ministry of Health and Social Development of the Russian FederationRussian Federation201017062025124265270Copyright © Приходина Л.С., Турпитко О.Ю., Длин В.В., Игнатова М.С., 20252025Приходина Л.С., Турпитко О.Ю., Длин В.В., Игнатова М.С.Prikhodina L.S., Turpitko O.Y., Dlin V.V., Ignatova M.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/1011

В статье представлены результаты проспективного одноцентрового исследования эффективности и безопасности терапии такролимусом стероид-резистентного нефротического синдрома (СРНС) у 8 детей. Стартовая доза такролимуса составляла 0,1 мг/кг/24 ч и назначалась в комбинации с преднизолоном в дозе 0,5–1,0 мг/кг/48 ч. Проводилась коррекция терапевтической дозы такролимуса в соответствии с концентрацией препарата в крови (5,0–10,0 нг/мл). Полная клинико-лабораторная ремиссия СРНС была достигнута у 3 (38%) детей, частичная у 2 (25%), отсутствие эффекта от терапии такролимусом наблюдалось у 3 (38%) больных. Полная ремиссия заболевания сохранялась после отмены препарата у всех 3 больных в течение 15 месяцев наблюдения. Побочные эффекты терапии такролимусом: гиперкалиемия у 4 (50%) детей, увеличение выраженности артериальной гипертензии – у 3 (38%), нефротоксичность – у 2 (25%), глюкозурия у 1 (13%). Представленные первые результаты исследования позволяют рассматривать такролимус в качестве эффективного иммуносупрессанта, способствующего индукции полной и частичной ремиссии заболевания у 63% детей со СРНС, включая резистентных к ранее проводимой иммуносупрессивной терапии.

The results of a prospective single-center study of efficacy and safety of tacrolimus therapy of steroid-resistant nephrotic syndrome (SRNS) in 8 children are presented. Initial tacrolimus dose of 0,1 mg/kg/24 h was combined with 0,5–1,0 mg/kg/48 h prednisolone. Tacrolimus dose was adjusted to achieve the target blood level of 5,0–10,0 ng/ml. Complete remission was achieved in 3 (38%) children, partial remission in 2 (25%) of them, 3 (38%) patients did not respond to tacrolimus. In 3 children the complete remission remained for 15 months after withdrawal of tacrolimus. The side effects observed were: hyperkalemia in 4 (50%) children, worsening of hypertension in 3 (38%), nephrotoxicity in 2 (25%), glycosuria in 1 (13%) case. Tacrolimus can be considered as effective immunosuppressive agent in children with SRNS.

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The authors declare that there are no conflicts of interest present.