丁周志难治性肾病的处理图文ppt课件.pptVIP

Progress of management of kidney diseases in children Advantages and disadvantages of corticosteroid-sparing agents as first agent for use in FR or SD SSNS Cyclophosphamide Advantages：Prolonged remission off therapy；Inexpensive Disadvantages：Less effective in SD SSNS；Monitoring of blood count during therapy；Potential serious short- and long-term adverse effects；Only one course should be given. Chlorambucil Advantages：Prolonged remission off therapy；Inexpensive Disadvantages：Less effective in SD SSNS；Monitoring of blood count during therapy；Potential serious adverse effects；Only one course should be given；Not approved for SSNS in some countries. KDIGO Advantages and disadvantages of corticosteroid-sparing agents as first agent for use in FR or SD SSNS Levamisole Advantages：Few adverse effects；Generally inexpensive Disadvantages：Continued treatment required to maintain remission；Limited availability；Not approved for SSNS in some countries. Mycophenolate mofetil Advantages：Prolonged remissions in some children with FR and SD SSNS；Few adverse effects Disadvantages：Continued treatment often required to maintain remission；Probably less effective than CNIs；Expensive；Not approved for SSNS in some countries. KDIGO Advantages and disadvantages of corticosteroid-sparing agents as first agent for use in FR or SD SSNS Cyclosporine Advantages：Prolonged remissions in some children with SD SSNS. Disadvantages：Continued treatment often required to maintain remission；Expensive；Nephrotoxic；Cosmetic side-effects. Tacrolimus Advantages：Prolonged remissions in some children with SD SSNS Disadvantages：Continued treatment often required to maintain remission；Expensive；Nephrotoxic；Risk of diabetes mellitus；Not approved for SSNS in some countries. KDIGO “不再使用”的免疫抑制剂 硫唑嘌呤 与单纯激素治疗和安慰剂治疗相比，硫唑嘌呤治疗在6个月时的复发率无差别，现已不建议临床应用。 咪唑立宾 与安慰剂相比，咪唑立宾治疗的复发率无差别。现已不建议临床应用。 KDIGO Indication for kidney biopsy 初始对激素治疗有效，后期出现治疗无效者； 高度怀疑另一种非微小病变的肾脏病理类型时； 在钙神经蛋白抑制剂治疗期间，出现肾功能减退者。 KDIGO Immunizations in children wi