Mycophenolate mofetil in children with steroid/cyclophosphamide-resistant nephrotic syndrome

Mycophenolate mofetil in children with steroid/cyclophosphamide-resistant nephrotic syndrome

Author Mello, Valderez Raposo de Google Scholar
Rodrigues, Maira Tinte Google Scholar
Mastrocinque, Tais Helena Google Scholar
Laranjo Martins, Simone Paiva Google Scholar
Braga de Andrade, Olberes Vitor Google Scholar
Medeiros Guidoni, Eliana Biondi Google Scholar
Scheffer, Daniel Kashiwamura Google Scholar
Martini Filho, Dino Google Scholar
Toporovski, Julio Google Scholar
Benini, Vanda Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Santa Casa São Paulo
Abstract The purpose of this study was to assess the results of therapy with mycophenolate mofetil (MMF) in children with idiopathic nephrotic syndrome (INS) who were both steroid- and cyclophosphamide-resistant. Treatment lasted a minimum of 6 months, and follow-up data were collected over a 2-year period. the children were divided into two groups: Group 1 (n = 34) comprised patients who had received cyclosporine A (CsA) before the initiation of MMF therapy; Group 2 (n = 18) comprised patients who received only MMF. Among the 34 patients of Group 1, complete and partial remission were achieved in seven (20.6%) and 13 patients (38.6%), respectively; there was no response in 14 patients (41.2%). Among the 18 patients in Group 2, complete and partial remission occurred in five (27.8%) and six (33.3%) patients, respectively; there was no response in seven patients (38.9%). Eight patients developed chronic kidney disease. the main side-effects were gastrointestinal complaints (n = 11, 21%), recurring severe infections (n = 1, 1.9%), and mild thrombocytopenia/leucopenia (n = 1, 1.9%). MMF proved to be therapeutically effective in 59.5% of the cases. These beneficial effects need to be confirmed in studies with a long-term follow-up after discontinuation of the treatment. Our statistical analysis of the results of therapy with MMF did not reveal any significant difference between its use alone or following CsA administration.
Keywords Cyclophosphamide resistant
Cyclosporine A
Mycophenolate mofetil
Nephrotic syndrome
Steroid resistant
Language English
Date 2010-03-01
Published in Pediatric Nephrology. New York: Springer, v. 25, n. 3, p. 453-460, 2010.
ISSN 0931-041X (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 453-460
Access rights Closed access
Type Article
Web of Science ID WOS:000273950600008

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