Clinical Observation Of Tacrolimus In The Treatment Of Children With Steroid Resistant Nephrotic Syndrome

Objective:This study was designed to evaluate the response rate of tacrolimus and security in patients with steroid-resistant nephrotic syndrome(SRNS).Methods:A prospective randomized controlled clinical trial was conducted in the Department of Pediatrics,First Affiliated Hospital of Kunming Medical University from September 2016 to January 2018,and 60 patients with steroid-resistant nephrotic syndrome were randomly divided into two groups:30 patients in the tacrolimus group,the methylprednisolone group30 children,were collected medical history data,laboratory data,T test,rank sum test or chi-square test,compare the treatment efficiency,frequency of recurrence,induction of remission Time,Renal function changes andadverse reactions.Results:At 4 weeks of treatment,16 patients(53.3%)had complete remission in the tacrolimus group,9 patients(30%)had partial remission,25 patients(83.3%)had total remission,and 11 patients(36.7%)in the methylprednisolone(MP)group were completely Remission,7 cases(23.3%)partial remission,total remission 18 cases(60%),there was a statistically significantdifference between the two groups(P<0.05);tacrolimus group median remission time was 12 days,methylprednisolone The median time to remission was 20.5 days,the difference was statistically significant(P<0.05).Duringfollow-up,22 patients in the tacrolimus group maintained remission,11 patients in the methylprednisolone group maintained remission,and the tacrolimus group Three patients had recurrence 3 times,and each patient had recurrence once.In 7 patients with methylprednisolone group,7 patients had recurrence 10 times(3 of them had recurrence 2 times and 4 patients had recurrence 1 time respectively).there was a statistically significant difference between the two groups(P<0.05);the duration of remission in the tacrolimus group was 10.87±0.757 months,and the duration of remission in the methylprednisolone group was 5.42±2.086 months.there was a statistically significantdifference between the two groups(P<0.05).Conclusion:1.For children with steroid-resistant nephrotic syndrome,tacrolimus treatment has a faster onset time,higher remission rate and lower recurrence rate than the sequential treatment of methylprednisolone.2.The incidence of adverse reactions of tacrolimus in children with steroid-resistant nephrotic syndrome is low,and children are well tolerated.