Montelukast as an add-on treatment in steroid dependant nephrotic syndrome, randomised-controlled trial

Background The underlying mechanisms of nephrotic syndrome (NS) are still under debate and the need for more effective and less toxic treatment is challenging. We aimed to evaluate the efficacy of montelukast, a leukotriene receptor antagonist as an add-on therapy, and to explore the leukotriene (LT...

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Published in:Journal of nephrology 2016-08, Vol.29 (4), p.585-592
Main Authors: Zedan, Magdy Mohamed, El-Refaey, Ahmed, Zaghloul, Hosam, Abdelrahim, Mohamed E. A., Osman, Amal, Zedan, Mohamed M., Eltantawy, Nashwa
Format: Article
Language:English
Subjects:
Acetates - administration & dosage
Adolescent
Child
Drug Therapy, Combination
Female
Follow-Up Studies
Glucocorticoids - administration & dosage
Humans
Kidney Function Tests
Leukotriene Antagonists - administration & dosage
Male
Medicine
Medicine & Public Health
Nephrology
Nephrotic Syndrome - drug therapy
Original Article
Quinolines - administration & dosage
Treatment Outcome
Urology
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Summary:Background The underlying mechanisms of nephrotic syndrome (NS) are still under debate and the need for more effective and less toxic treatment is challenging. We aimed to evaluate the efficacy of montelukast, a leukotriene receptor antagonist as an add-on therapy, and to explore the leukotriene (LT) biology in steroid-dependent nephrotic syndrome (SDNS). Methods A randomized controlled trial was conducted including 32 patients with SDNS who were randomly assigned to receive standard steroid treatment only [low-dose steroid (LDS) group] or standard steroid therapy plus montelukast (Montelukast group). Urine protein/creatinine ratio, serum albumin, creatinine, cholesterol, and plasma LTs (LTB4/C4/D4/E4) were evaluated in all patients before and after treatment. Results After treatment, both groups showed a significant decrease of LTB4 and LTC4/D4/E4. Further, the Montelukast group showed a significant decrease in serum creatinine and a significant increase in diastolic blood pressure and protein/creatinine ratio. It also showed a marked decrease in plasma LTC4/D4/E4 compared to the LDS group, although not statistically significant. Conclusions Our findings highlight the effect of montelukast on renal function, but suggest that the clinical and laboratory efficacy of the addition of montelukast to steroids in maintenance treatment of SDNS is debatable.
ISSN:1121-8428
1724-6059
DOI:10.1007/s40620-016-0297-2