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Mycophenolate mofetil treatment for primary glomerular diseases
Michael J Choi1, Joseph A Eustace, Luis F Gimenez
1Nephrology Division, Johns Hopkins University School of Medicine, 1830 E. Monument Street, Baltimore, MD 21205-2196, USA. mchoi3@jhmi.edu
Kidney International
|February 19, 2002
Summary
Mycophenolate mofetil (MMF) effectively treated primary glomerulopathies, reducing proteinuria and improving nephrotic syndrome. This empirical therapy was well-tolerated, aiding steroid withdrawal and stabilizing kidney function in patients.
Area of Science:
- Nephrology
- Immunosuppression
- Glomerular Diseases
Background:
- Primary glomerulopathies often resist conventional treatment or cause toxicity.
- Evaluating mycophenolate mofetil (MMF) as an empirical therapy for primary glomerulopathies is crucial.
Purpose of the Study:
- To assess the efficacy and tolerability of empirical mycophenolate mofetil (MMF) in patients with primary glomerulopathies.
- To evaluate MMF's impact on proteinuria, renal function, and steroid dependence.
Main Methods:
- Forty-six patients with biopsy-proven primary glomerulopathies received MMF for at least 3 months.
- Compared 24-hour urine protein-to-creatinine ratio (Up/c) and serum creatinine before and after MMF therapy.
Main Results:
- Median Up/c significantly decreased from 4.7 to 1.1 (P < 0.001), with improved serum albumin and reduced cholesterol.
- Steroid withdrawal was achieved in 5/6 steroid-dependent minimal change disease patients.
- Significant proteinuria reduction observed in focal segmental glomerulosclerosis (FSGS) and membranous nephropathy (MN) patients without affecting serum creatinine.
Conclusions:
- Empirical MMF therapy is well-tolerated for primary glomerulopathies.
- MMF effectively reduces proteinuria, improves nephrotic syndrome, and stabilizes renal function.
- MMF facilitates steroid withdrawal in select patients.