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[Mycophenolate mofetil in high risk IgA glomerulonephritis]
M A Frutos1, V López, M J Alférez
1Servicio de Nefrología, Hospital Regional Universitario de Málaga. mangel.frutos.sspa@juntadeandalucia.es
Nefrologia : Publicacion Oficial De La Sociedad Espanola Nefrologia
|October 20, 2005
Summary
Mycophenolate mofetil (MMF) may stabilize Mesangial IgA glomerulonephritis (MIgAGn) and reduce proteinuria in high-risk patients with early kidney failure. MMF was well tolerated and showed potential benefit in a subgroup with poor prognosis.
Area of Science:
- Nephrology
- Immunology
Background:
- Mesangial IgA glomerulonephritis (MIgAGn) is the most common primary glomerulonephritis, often leading to poor renal function prognosis.
- Currently, no definitive therapy exists for MIgAGn, despite some studies suggesting benefits from mycophenolate mofetil (MMF).
Purpose of the Study:
- To evaluate the efficacy and tolerability of compassionate use of MMF in adult patients with biopsy-proven MIgAGn at high risk of renal failure.
Main Methods:
- Eight adult patients with MIgAGn received standard care plus MMF.
- Two patients with advanced renal failure discontinued MMF early due to progression.
- Six patients completed a mean of 15 months of MMF therapy.
Main Results:
- Serum creatinine decreased from 1.82 to 1.55 mg/dl (p=0.04) and proteinuria reduced from 1.95 to 0.77 g/day (p=0.02) in patients completing MMF therapy.
- MMF was generally well tolerated.
- Two patients with advanced disease at baseline progressed to dialysis and transplantation.
Conclusions:
- MMF may stabilize early-stage kidney failure and reduce proteinuria in a subgroup of high-risk MIgAGn patients.
- MMF appears to be a potentially beneficial and well-tolerated treatment option for select MIgAGn patients with poor prognosis.