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Protective effect of mycophenolate mofetil on residual renal function in peritoneal dialysis patients: An open label
Xiaoyang Wang1, Xiaoxue Zhang1, Shan Lu1
1Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Nephropathy Research Institutes of Zhengzhou University, Zhengzhou, China.
Aim:
This study aims to evaluate the safety of mycophenolate mofetil (MMF) and its effect on residual renal function (RRF) during peritoneal dialysis (PD).
Methods:
This is a prospective, randomized study comprising 60 PD patients. The patients were assigned either to the MMF group (MMF dosage: 1.0-1.5 g/day in two divided doses for 6 months, followed by a dose of 0.5-0.75 g/day for another 6 months) or to the control group. The patients close monitoring for 1 year. Variables related to residual renal function, including urine volume, measured glomerular filtration rate (GFR), and renal Kt/V, were measured at four time points.
Results:
There were no significant changes in urinary protein excretion in either group (P > 0.05). The MMF group showed a significantly higher urine volume than the control group (955.38 ± 243.54 vs 786.15 ± 279.62 mL/day, P = 0.024). The renal kt/V was also significantly higher in the MMF group (0.59 ± 0.11 in MMF vs 0.50 ± 0.19 in control group, P = 0.032). There was significant difference in the renal measured GFR between the two groups at 6, 9 and 12 months (MMF vs control at 6 months, 6.14 ± 0.66 vs 5.58 ± 0.65 mL/min per 1.73m2 , P = 0.003; at 9 months, 5.68 ± 0.80 vs 4.78 ± 0.75, P < 0.001; at 12 months, 5.44 ± 0.91 vs 4.43 ± 0.93, P < 0.001). MMF was well tolerated without any serious complications.
Conclusion:
The use of MMF in PD patients tends to better preserve RRF.
Insights
Mycophenolate mofetil (MMF) use in peritoneal dialysis (PD) patients appears to preserve residual renal function (RRF). This prospective study found MMF improved urine volume and GFR without serious complications.
Area of Science:
- Nephrology
- Immunosuppression
- Renal Replacement Therapy
Background:
- Peritoneal dialysis (PD) is a crucial renal replacement therapy.
- Maintaining residual renal function (RRF) is vital for PD patient outcomes.
- The safety and efficacy of immunosuppressants on RRF in PD patients require further investigation.
Purpose of the Study:
- To assess the safety of mycophenolate mofetil (MMF) in PD patients.
- To evaluate the impact of MMF on residual renal function (RRF) during PD therapy.
- To compare RRF parameters between PD patients treated with MMF and a control group.
Main Methods:
- A prospective, randomized study involving 60 PD patients.
- Patients were assigned to either an MMF group or a control group for 12 months.
- Residual renal function (urine volume, GFR, Kt/V) was monitored at multiple time points.
Main Results:
- MMF treatment led to significantly higher urine volume and renal Kt/V compared to the control group.
- A significant difference in measured GFR was observed favoring the MMF group at 6, 9, and 12 months.
- Mycophenolate mofetil was well-tolerated, with no serious complications reported.
Conclusions:
- Mycophenolate mofetil (MMF) use in PD patients is safe.
- MMF demonstrates a trend towards better preservation of residual renal function (RRF) in PD patients.
- Further research may solidify MMF's role in optimizing RRF management for PD patients.
