Comparison of the Safety of Prednisone Plus Dipyridamole Versus Prednisone Plus Valsartan in the Treatment of Children with Primary Nephrotic Syndrome
Keywords:
Nephrotic syndrome, Prednisone, Dipyridamole, Valsartan, Kidney functionAbstract
Introduction. In recent years, the incidence of pediatric nephrotic syndrome (NS) has been increasing, and timely and effective treatment is critical to protect the health of children with NS. This study is an attempt to compare the therapeutic effects of prednisone (Pred) plus dipyridamole (DIP) versus Pred plus valsartan (VAL)on pediatric NS.
Methods. Two hundred pediatric cases of NS were selected as the research participants, including 109 cases (group A) receiving Pred + DIP and 91 cases (group B) receiving Pred + VAL. The clinical
efficacy, adverse reactions, and renal, coagulation functions and blood lipid levels, as well as the pre- and post-treatment levels of inflammatory factors (IFs) and immunoglobulins (Igs) were
comparatively analyzed.
Results. No statistically significant differences were found between groups in terms of clinical efficacy, incidence of adverse reactions and renal function (P > .05). After receiving the corresponding treatment, group A showed better coagulation and immune functions than group B, but higher levels of IFs and poorer blood lipid function (P < .05).
Conclusion. Both Pred + DIP and Pred + VAL combination therapies can be used for the treatment of pediatric NS, with the former contributing to more obviously enhanced coagulation and immune functions, and the latter leading to more significantly inhibited inflammation and better regulated blood lipid function.
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References
POLITANO SA, COLBERT GB, HAMIDUZZAMAN N. Nephrotic Syndrome [J]. Prim Care. 2020;47(4):597-613.
TRAUTMANN A, BOYER O, HODSON E, et al. IPNA clinical practice recommendations for the diagnosis and management of children with steroid-sensitive nephrotic syndrome [J]. Pediatr Nephrol. 2023;38(3):877-919
LEI J, MA S. Relationship between TIM-3 gene polymorphisms and steroid-resistant primary nephrotic
syndrome in children [J]. Cell Mol Biol (Noisy-le-grand). 2020;66(7):72-75.
NOONE DG, IIJIMA K, PAREKH R. Idiopathic nephrotic syndrome in children [J]. Lancet. 2018;392(10141):61-74.
BOROVITZ Y, ALFANDARY H, HASKIN O, et al. Lower prednisone dosing for steroid-sensitive nephrotic
syndrome relapse: a prospective randomized pilot study. Eur J Pediatr [J]. 2020;179(2):279-283.
SIBLEY M, ROSHAN A, ALSHAMI A, ET AL. Induction prednisone dosing for childhood nephrotic syndrome: how low should we go? [J] Pediatr Nephrol. 2018;33(9):1539-1545.
KERNDT CC, NAGALLI S. Dipyridamole [M] In: StatPearls. Treasure Island (FL) ineligible companies.
Disclosure: Shivaraj Nagalli declares no relevant financial relationships with ineligible companies. 2023.
ALLAHHAM M, LERMAN A, ATAR D, BIRNBAUM Y. Why Not Dipyridamole: a Review of Current Guidelines and Re-evaluation of Utility in the Modern Era. Cardiovasc Drugs Ther [J]. 2022;36(3):525-532.
BRAUN WE, HERLITZ L, LI J, et al. Continuous function of 80 primary renal allografts for 30-47 years with
maintenance prednisone and azathioprine/mycophenolate mofetil therapy: A clinical mosaic of long-term successes [J]. Clin Transplant. 2021;35(1):e14131.
LIU Y, GUAN Y, LIU H, BIAN Q. Highly suspected valsartan-induced chronic erythema nodosum migrans in a patient with hypertension: a case report [J]. J Int Med Res. 2022;50(2):3000605221079553.
HAMPSON KJ, GAY ML, BAND ME. Pediatric Nephrotic Syndrome: Pharmacologic and Nutrition Management [J]. Nutr Clin Pract. 2021;36(2):331-343.
VIVARELLI M, GIBSON K, SINHA A, BOYER O. Childhood nephrotic syndrome [J]. Lancet.
;402(10404):809-824.
ABUMAZIAD AS, ABUSALEH R, BHATI S. Congenital nephrotic syndrome [J]. J Perinatol. 2021;41(12):2704- 2712.
NOLIN L, COURTEAU M. Management of IgA nephropathy: evidence-based recommendations [J].
Kidney Int Suppl. 1999;70:S56-62.
NAKAMAE H, TSUMURA K, TERADA Y, et al. Notable effects of angiotensin II receptor blocker, valsartan, on acute cardiotoxic changes after standard chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone [J]. Cancer. 2005;104(11):2492-2498.
PEREZ-CORTES G, PEREZ-MOLINA JJ, OCHOAPONCE C, RAMIREZ-GODINEZ S, ORNELAS-ALVAREZ
VM. [Proteinuria selectivity and prednisone response in children with nephrotic syndrome]. Rev Med Inst Mex Seguro Soc. 2020;58(3):298-304.
HAHN D, SAMUEL SM, WILLIS NS, CRAIG JC, HOBSON EM. Corticosteroid therapy for nephrotic
syndrome in children. Cochrane Database Syst Rev. 2020;2020(8):CD001533.
GARGIULO A, MASSELLA L, RUGGIERO B, et al.
Results of the PROPINE randomized controlled study suggest tapering of prednisone treatment for relapses of steroid sensitive nephrotic syndrome is not necessary in children [J]. Kidney Int. 2021;99(2):475-483.
ABDELGHANY L, EL-MAHDY N, KAWABATA T, GOTO S, LI TS. Dipyridamole induces the phosphorylation of CREB to promote cancer cell proliferation [J]. Oncol Lett. 2021;21(4):251.
KALAYOGLU BESISIK S, OZBALAK M, TOR YB, et al. Dipyridamole does not have any additive effect on the prevention of COVID-19 coagulopathy. Am J Blood Res. 2022;12(2):54-59.
KUO KL, HUNG SC, TSENG WC, et al. Dipyridamole decreases dialysis risk and improves survival in
patients with pre-dialysis advanced chronic kidney disease [J]. Oncotarget. 2018;9(4):5368-5377.
PONTREMOLI R, BORGHI C, PERRONE FILARDI P. Renal protection in chronic heart failure: focus on
sacubitril/valsartan. Eur Heart J Cardiovasc Pharmacother [J]. 2021;7(5):445-452.
WANG SJ, SANDER GE. Nebivolol/valsartan combination for the treatment of hypertension: a review [J]. Future Cardiol. 2021;17(4):573-583.
