Cyclophosphamide therapy in adults with minimal-change nephrotic syndrome

Ten adults with minimal-change nephrotic syndrome, eight of whom had failed to respond satisfactorily to steroid therapy, have been treated with cyclophosphamide. Eight patients are now in remission with protein-free urine 2-46 months after withdrawal of all treatment. The remaining two patients have had a partial remission. The only serious side-effect was permanent secondary amenorrhoœa in a 31-year-old woman treated with cyclophosphamide for 20 months. It is suggested that cyclophosphamide should be tried in any adult with minimal-change nephrotic syndrome who does not respond to prednisone within 2 months.