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. 2011 Dec 31;7(6):1042-8.
doi: 10.5114/aoms.2011.26618. Epub 2011 Dec 30.

Mycophenolate mofetil (MMF) treatment efficacy in children with primary and secondary glomerulonephritis

Danuta Ostalska-Nowicka  1 , Agnieszka Malinska, Magdalena Silska, Bartlomiej Perek, Jacek Zachwieja, Michal Nowicki
Affiliations

Mycophenolate mofetil (MMF) treatment efficacy in children with primary and secondary glomerulonephritis

Danuta Ostalska-Nowicka et al. Arch Med Sci. .

Abstract

Introduction: The aim of our study was to analyse the efficacy and safety of mycophenolate mofetil (MMF) as part of the complex immunosuppressive therapy in children with different types of primary and secondary glomerulonephritis, who were not eligible for the standard treatment routine suggested by evidence-based guidelines.

Material and methods: The study group comprised 85 children with proteinuric glomerulopathies hospitalized between 2007 and 2010, who were non-responders to immunosuppressive therapy. The dose of MMF was established as 1 g/m(2)/24 h. Remission was defined as negative proteinuria in three consecutive urinalyses.

Results: The patients were divided into 4 groups: idiopathic nephrotic syndrome (n = 35), primary glomerulonephritis (n = 15), auto-antibody associated glomerulonephritis (n = 20) and lupus nephropathy (LN, n = 15). Ten patients from the first group (29%) and 5 patients each from the second and third group (34% and 25% respectively) did not respond to MMF therapy. On the other hand, all the children diagnosed with LN have reached clinical and biochemical remission.

Conclusions: Alternative rescue MMF therapy should always be taken into consideration in proteinuric patients who are non-responders to steroids, cyclosporine A and cyclophosphamide in whom the initial glomerular filtration rate is higher than 60 ml/min/1.73m(2). It is recommended that MMF be administered as part of the standard treatment regimen in patients diagnosed with lupus nephropathy. In these groups of patients, the potent benefits of this therapy are higher than expected side-effects.

Keywords: mycophenolate mofetil; nephrotic syndrome; outcome; paediatrics.

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Figures

Figure 1
Figure 1
Proteinuria (mg/kg/24 h) in children with primary and secondary glomerulonephritis during MMF therapy
Figure 2
Figure 2
GFR (ml/min/1.73 m2) of children with primary and secondary glomerulonephritis during MMF therapy
See this image and copyright information in PMC

References

    1. Hallan SI, Ritz E, Lydersen S, et al. Combining GFR and albuminuria to classify CKD improves prediction of ESRD. J Am Soc Nephrol. 2009;20:1069–77. - PMC - PubMed
    1. Mathieson PW. Minimal change nephropathy and focal segmental glomerulosclerosis. Semin Immunopathol. 2007;29:415–26. - PubMed
    1. Chesney RW. The idiopathic nephrotic syndrome. Curr Opin Pediatr. 1999;11:158–61. - PubMed
    1. Swartz SJ, Eldin KW, Hicks MJ, Feig DI. Minimal change disease with IgM+ immunofluorescence: a subtype of nephrotic syndrome. Pediatr Nephrol. 2009;24:1187–92. - PubMed
    1. Fogo AB. Minimal change disease and focal segmental glomerulosclerosis. Nephrol Dial Transplant. 2001;16:74–6. - PubMed

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