{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T17:29:14Z","timestamp":1786728554270,"version":"build-2736575974"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:p>\n                    Nephrotic syndrome (NS) is a chronic renal disease that can progress into end-stage renal disease within 5 years if no remission occurs. Achieving optimal remission is important to obtain better outcomes of treating childhood steroid-resistant NS (SRNS). This study aimed to determine the survival, long-term outcomes, and factors associated with the sustained remission of SRNS patients after cyclophosphamide therapy. We retrospectively studied 33 children (24 boys) with SRNS treated with cyclophosphamide therapy over 2 years. Relapse-free survival was estimated using the Kaplan\u2013Meier method. The determinants of long-term remission were assessed by univariate and multivariate analyses using Cox's proportional hazard models. The median age at the onset of NS was 3.0 years (range: 7 months to 14.0 years). The median age at the initiation of cyclophosphamide therapy was 5.0 years (range: 1.0\u201315.0 years). The mean cumulative cyclophosphamide dose was 155.61 \u00b1 16.31 mg\/kg body weight. In total, 18 of 33 (54.5%) children remained in remission for 2 years after cyclophosphamide therapy, and 10 of 15 patients who relapsed (66.67%) became steroid sensitive. Relapse-free survival after cyclophosphamide therapy was 78.8%, 69.7%, and 54.5% after 6, 12, and 24 months, respectively. Cox's proportional hazard regression identified no association between remission 2 years after cyclophosphamide therapy and other factors, such as age at the onset of SRNS, type of resistance, hypertension, hematuria, administration route of cyclophosphamide, and cumulative dose (all\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &gt;0.05). Cyclophosphamide therapy appeared to be beneficial for children with SRNS for sustaining 2-year remission with a 54.5% relapse-free survival rate.\n                  <\/jats:p>","DOI":"10.4103\/1319-2442.384185","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T04:44:50Z","timestamp":1692679490000},"page":"S129-S137","source":"Crossref","is-referenced-by-count":1,"title":["Long-Term Effects of Cyclophosphamide in Sustained Remission in Childhood Steroid-resistant Nephrotic Syndrome"],"prefix":"10.4103","volume":"33","author":[{"given":"Eka L.","family":"Hidayati","sequence":"first","affiliation":[{"name":"Department of Child Health, Faculty of Medicine, Cipto Mangunkusumo National Hospital, Universitas Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimas D.","family":"Saputro","sequence":"additional","affiliation":[{"name":"Department of Child Health, Faculty of Medicine, Cipto Mangunkusumo National Hospital, Universitas Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laksmi","family":"Bestari","sequence":"additional","affiliation":[{"name":"Department of Child Health, Faculty of Medicine, Cipto Mangunkusumo National Hospital, Universitas Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zakiudin","family":"Munasir","sequence":"additional","affiliation":[{"name":"Department of Child Health, Faculty of Medicine, Cipto Mangunkusumo National Hospital, Universitas Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achmad","family":"Rafli","sequence":"additional","affiliation":[{"name":"Department of Child Health, Faculty of Medicine, Cipto Mangunkusumo National Hospital, Universitas Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,8,22]]},"reference":[{"key":"R1-20230915","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1007\/s00467-009-1138-5","article-title":"Long-term outcome of idiopathic steroid-resistant nephrotic syndrome: A multicenter study","volume":"24","author":"Mekahli","year":"2009","journal-title":"Pediatr Nephrol"},{"key":"R2-20230915","doi-asserted-by":"crossref","first-page":"266","DOI":"10.14238\/pi51.5.2011.266-71","article-title":"Comparison of oral and intravenous cyclophos-phamide in children with steroid-resistant nephrotic syndrome","volume":"51","author":"Hidayati","year":"2011","journal-title":"Paediatr Indones"},{"key":"R3-20230915","first-page":"210","article-title":"Management and outcome of steroid-resistant nephrotic syndrome in children","volume":"3","author":"Otukesh","year":"2009","journal-title":"Iran J Kidney Dis"},{"key":"R4-20230915","first-page":"39","article-title":"Steroid resistant nephrotic syndrome is sustained remission attainable","volume":"43","author":"Nammalwar","year":"2006","journal-title":"Indian Pediatr"},{"key":"R5-20230915","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1542\/pir.23.7.237","article-title":"Nephrotic syndrome: Pathogenesis and management","volume":"23","author":"Roth","year":"2002","journal-title":"Pediatr Rev"},{"key":"R6-20230915","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1007\/BF02724390","article-title":"Steroid resistant nephrotic syndrome","volume":"69","year":"2002","journal-title":"Indian J Pediatr"},{"key":"R7-20230915","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/S0022-3476(05)82020-7","article-title":"Treatment of childhood steroid-resistant idiopathic nephrosis with a combi-nation of cyclosporine and prednisone. French Society of Pediatric Nephrology","volume":"125","year":"1994","journal-title":"J Pediatr"},{"key":"R8-20230915","first-page":"484","article-title":"Treatment of steroid resistant nephrotic syndrome in children","volume":"21","author":"Kari","year":"2010","journal-title":"Saudi J Kidney Dis Transpl"},{"key":"R9-20230915","doi-asserted-by":"crossref","first-page":"191","DOI":"10.5935\/0101-2800.20130031","article-title":"Steroid-resistant idiopathic nephrotic syndrome in children: Long-term follow-up and risk factors for end-stage renal disease","volume":"35","author":"Zagury","year":"2013","journal-title":"J Bras Nefrol"},{"key":"R10-20230915","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1007\/s00467-005-2097-0","article-title":"Differential risk of remission and ESRD in childhood FSGS","volume":"21","author":"Gipson","year":"2006","journal-title":"Pediatr Nephrol"},{"key":"R12-20230915","first-page":"55","article-title":"Steroid resistant nephrotic syndrome: Role of histo-pathology","volume":"43","author":"Gulati","year":"2006","journal-title":"Indian Pediatr"},{"key":"R13-20230915","first-page":"208","article-title":"Cyclophosphamide in children with idiopathic nephrotic syndrome","volume":"3","author":"Yadav","year":"2014","journal-title":"Int J Sci Invent"},{"key":"R14-20230915","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/S0022-3476(81)80760-3","article-title":"The primary nephrotic syndrome in children. Identification of patients with minimal change nephrotic syndrome from initial response to prednisone","volume":"98","author":"Barnett","year":"1981","journal-title":"J Pediatr"},{"key":"R15-20230915","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1007\/s00467-003-1095-3","article-title":"Intravenous cyclophosphamide in steroid-resistant nephrotic syndrome","volume":"18","author":"Bajpai","year":"2003","journal-title":"Pediatr Nephrol"},{"key":"R16-20230915","doi-asserted-by":"crossref","first-page":"4506","DOI":"10.1177\/0300060518782017","article-title":"Cyclophosphamide versus cyclosporine A therapy in steroid-resistant nephrotic syndrome: A retrospective study with a mean 5-year follow-up","volume":"46","author":"Liu","year":"2018","journal-title":"J Int Med Res"},{"key":"R17-20230915","first-page":"CD003594","article-title":"Interventions for idiopathic steroid-resistant nephrotic syndrome in children","volume":"10","author":"Hodson","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"R18-20230915","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s00467-015-3174-7","article-title":"Long-term outcome of idiopathic steroid-resistant nephrotic syndrome in children","volume":"31","author":"Inaba","year":"2016","journal-title":"Pediatr Nephrol"},{"key":"R19-20230915","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1093\/ndt\/gfq405","article-title":"Long-term effects of cyclophosphamide therapy in steroid-dependent or frequently relapsing idiopathic nephrotic syndrome","volume":"26","author":"Cammas","year":"2011","journal-title":"Nephrol Dial Transplant"},{"key":"R20-20230915","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1136\/bmj.4.5935.7","article-title":"Long-term stability of remission in nephrotic syndrome after treatment with cyclophos-phamide","volume":"4","author":"Cameron","year":"1974","journal-title":"Br Med J"},{"key":"R21-20230915","first-page":"167","article-title":"Treatment with cyclophosphamide for steroid-resistant nephrotic syndrome in children","volume":"5","author":"Cucer","year":"2010","journal-title":"Maedica (Bucur)"},{"key":"R22-20230915","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1007\/s00467-003-1170-9","article-title":"Cyclophosphamide in steroid-sensitive nephrotic syndrome: Outcome and outlook","volume":"18","author":"Vester","year":"2003","journal-title":"Pediatr Nephrol"}],"container-title":["Saudi Journal of Kidney Diseases and Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/1319-2442.384185","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T16:28:35Z","timestamp":1786724915000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/1319-2442.384185"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":21,"journal-issue":{"issue":"Suppl 2","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/1319-2442.384185","relation":{},"ISSN":["1319-2442","2320-3838"],"issn-type":[{"value":"1319-2442","type":"print"},{"value":"2320-3838","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4]]}}}