الفهرس 
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Abstract
This study was conducted in pediatric nephrology unit and clinic over a period of one year. Total 50 patient aged from 1 to 18 years were included in the study and were divided into two groups, a steroid dependent group (29 patients) and a steroid resistant group (21 patients). All these cases are subjected to detailed history, full examinations, investigations as indicated and availableEthical consideration was followed during work and explained to each patient before beginning of the process 76.2% of the steroid resistant group achieved complete remission at the 4th month and 85.7% achieved complete remission at the end of our study In the steroid dependent group number of relapses was ranging from 2 – 4 relapses per patient per year before starting Cys A with a mean of 3.17 relapses this number of relapses was decreased to a range of 1-2 relapses per patient per year with a mean of 0.55 relapses by a percentage of 82.6% with a p value of <0.001. the dose of steroid before starting CysA was ranging between 1-1.5 mg/kg/day with a mean dose of 1.25 mg/kg /day, it was decreases to dose ranging between 0 - 1 mg/kg /day with a mean dose of 0.39 mg/kg/day by a percentage of 69% and a p value <0.001. Side effects of Cys A was monitored in the whole 50 patients from the start of therapy over one year. At the end of our study (6%) of patients had gum hyperplasia, (8%) of patients had hirsuitism, signs of infection in (16 %) of patients, hypertension in (18 %)of patients, nephrotoxicity in (8%) of patients other side effects as headache, abdominal pain and tremors in (16%) of patients. It was concluded that Cys A drug is a safe and effective drug in inducing and maintenance of remission in steroid resistant pediatric nephrotic syndrome. and it is safe and effective steroid sparing drug in pediatric steroid dependent nephrotic syndrome and it is effective in better control of steroid dependent nephrotic syndrome maintaining remission and decreasing number of relapses. Cys A drug is strongly recommended in management of steroid resistant nephrotic syndrome and steroid dependent nephrotic syndrome but with strict monitoring of its side effects.