Abstract: TH-PO160

Cetirizine and Montelukast Combination Therapy in Patients with Minimal Change Nephrotic Syndrome Concomitant with Allergic Disorders: A Single Center Study

Session Information

Category: Glomerular

  • 1005 Clinical Glomerular Disorders

Authors

  • Oshima, Yoichi, Toranomon Hospital, Kawasaki, Kanagawa, Japan
  • Sumida, Keiichi, Toranomon Hospital, Kawasaki, Kanagawa, Japan
  • Yamanouchi, Masayuki, Toranomon Hospital, Kawasaki, Kanagawa, Japan
  • Hoshino, Junichi, Toranomon Hospital, Kawasaki, Kanagawa, Japan
  • Ubara, Yoshifumi, Toranomon Hospital, Kawasaki, Japan
Background

In minimal change nephrotic syndrome (MCNS) glucocorticoid treatment is a major therapeutic option; however glucocorticoid may cause many adverse effects since most patients with MCNS are dependent on glucocorticoid. It is known that MCNS often complicates with allergic diseases. We investigated if anti-allergy therapy with cetirizine and montelukast have therapeutic effect in disease control for MCNS.

Methods

We identified 125 patients who were diagnosed as MCNS by renal biopsy in our hospital between 1985 and 2015. As shown in figure 1, 15 patients were included in this study. Patients were evaluated by minimum glucocorticoid maintenance dose.

Results

Average age at the time of onset was 33.2 years. Nine out of 15 patients were men (60%). Average number of relapses was 4.3 times. Average duration of corticosteroid treatment before the study was 211.3 months. Complicated allergic disorders were allergic rhinitis in ten patients (66.7%), atopic dermatitis in eight (53.3%), sinusitis in five (33.3%), drug allergy in four (26.7%), food allergy in three (20%), and asthma in two (13.3%). Average predonisolone dose at the start of the study was 3.78 (range: 0.5-10) (mg/day). Eleven patients (73%) became glucocorticoid free without relapse for more than 28 months, while only three relapsed (20%). After the treatment, minimum predonisolone maintenance dose was 0.038 (mg/day) compared to 0.858 (range: 0-4) (mg/day) before the treatment (p=0.042, Wilcoxon nonparametric paired test).

Conclusion

Cetirizine and montelukast therapy may have steroid sparing effect in allergy concomitant relapsing MCNS.

Funding

  • Private Foundation Support