BACKGROUND: A small proportion of patients with initially steroid-sensitive nephrotic syndrome relapse frequently, despite treatment with cyclophosphamide and/or cyclosporin. We investigated the efficacy of mycophenolate mofetil (MMF) in this group. METHODS: Seven patients with nephrotic syndrome due to minimal change nephropathy (MCN) or classical focal segmental glomerulosclerosis (FSGS) who had suffered multiple relapses over many years despite treatment with several different agents were commenced on MMF 1 g twice daily, together with a reducing dose of corticosteroids. RESULTS: Six patients went into complete remission and the seventh into partial remission. At 1 year, five remained in complete remission. The median (range) serum albumin concentration rose from 19 g/l (16-42 g/l) pre-MMF to 42 g/l (25-45 g/l) after 12 months (P=0.023), and the median (range) dose of prednisolone fell from 40 mg/day (30-60 mg/day) to 7.5 mg/day (0-40 mg/day) at 12 months (P=0.0008). CONCLUSION: MMF appears to be of benefit in the treatment of multiply relapsing nephrotic syndrome caused by MCN or FSGS. Controlled trials are required to establish the role of MMF in these disorders.
BACKGROUND: A small proportion of patients with initially steroid-sensitive nephrotic syndrome relapse frequently, despite treatment with cyclophosphamide and/or cyclosporin. We investigated the efficacy of mycophenolate mofetil (MMF) in this group. METHODS: Seven patients with nephrotic syndrome due to minimal change nephropathy (MCN) or classical focal segmental glomerulosclerosis (FSGS) who had suffered multiple relapses over many years despite treatment with several different agents were commenced on MMF 1 g twice daily, together with a reducing dose of corticosteroids. RESULTS: Six patients went into complete remission and the seventh into partial remission. At 1 year, five remained in complete remission. The median (range) serum albumin concentration rose from 19 g/l (16-42 g/l) pre-MMF to 42 g/l (25-45 g/l) after 12 months (P=0.023), and the median (range) dose of prednisolone fell from 40 mg/day (30-60 mg/day) to 7.5 mg/day (0-40 mg/day) at 12 months (P=0.0008). CONCLUSION:MMF appears to be of benefit in the treatment of multiply relapsing nephrotic syndrome caused by MCN or FSGS. Controlled trials are required to establish the role of MMF in these disorders.
Authors: Shreya Kangovi; Meredith Edwards; Stephen Woloszynek; Nandita Mitra; Harold Feldman; Bernard S Kaplan; Kevin E Meyers Journal: Pediatr Nephrol Date: 2011-11-25 Impact factor: 3.714
Authors: Ronald J Hogg; Aaron Friedman; Tom Greene; Milena Radeva; Milos N Budisavljevic; Jennifer Gassman; Debbie S Gipson; J Ashley Jefferson; Eunice G John; Frederick J Kaskel; Asha Moudgil; Marva Moxey-Mims; Luis A Ortiz; Jeffrey R Schelling; William Schnaper; Tarak Srivastava; Howard Trachtman; V Matti Vehaskari; Craig Wong; Robert P Woronieki; Scott K Van Why; Anna Zolotnitskaya Journal: Clin J Am Soc Nephrol Date: 2012-11-08 Impact factor: 8.237
Authors: Jonathan Hogan; Andrew S Bomback; Kshama Mehta; Pietro A Canetta; Maya K Rao; Gerald B Appel; Jai Radhakrishnan; Richard A Lafayette Journal: Clin J Am Soc Nephrol Date: 2013-09-05 Impact factor: 8.237