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Use of mycophenolate mofetil in steroid-dependent and -resistant nephrotic syndrome

dc.contributor.authorBarletta, Gina-Marieen_US
dc.contributor.authorBunchman, Timothy E.en_US
dc.contributor.authorFlynn, Joseph T.en_US
dc.contributor.authorKershaw, David B.en_US
dc.contributor.authorSmoyer, William E.en_US
dc.date.accessioned2006-09-11T19:25:57Z
dc.date.available2006-09-11T19:25:57Z
dc.date.issued2003-08en_US
dc.identifier.citationBarletta, Gina-Marie; Smoyer, William E.; Bunchman, Timothy E.; Flynn, Joseph T.; Kershaw, David B.; (2003). "Use of mycophenolate mofetil in steroid-dependent and -resistant nephrotic syndrome." Pediatric Nephrology 18(8): 833-837. <http://hdl.handle.net/2027.42/47822>en_US
dc.identifier.issn1432-198Xen_US
dc.identifier.issn0931-041Xen_US
dc.identifier.urihttps://hdl.handle.net/2027.42/47822
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=12774223&dopt=citationen_US
dc.description.abstractCyclosporin (Cs-A) is an effective treatment for difficult cases of nephrotic syndrome (NS), but its use can be complicated by renal toxicity and a high incidence of relapses after withdrawal. We reviewed the charts of 10 Cs-A-dependent patients and 4 patients with steroid-dependent nephrotic syndrome (SDNS) not previously treated with Cs-A therapy. All patients had persistent NS, even after prior treatment with oral cyclophosphamide. Of 10 patients treated with Cs-A, 4 had surveillance renal biopsies consistent with Cs-A toxicity, and 8 of 10 had interstitial fibrosis prior to mycophenolate mofetil (MMF). Patients were treated with MMF, at 1,200 mg/m 2 per day, in an attempt to allow weaning of Cs-A and/or steroid therapy, and reduce the frequency of relapses. Overall, a significant decrease in frequency of relapses was noted after initiation of MMF therapy. In addition, 5 patients were weaned off Cs-A by 1–2 years of follow-up. One patient was weaned off Cs-A and MMF, and remained in complete remission. However, the subgroup of patients with frequently relapsing SDNS not treated with Cs-A appeared to have a reduction in the number of relapses while on MMF that did not reach statistical significance. Two patients with intractable steroid-resistant NS continued to relapse repeatedly on MMF and Cs-A therapy. We conclude that in this small, single-center, uncontrolled experience, MMF therapy in patients with Cs-A-dependent NS appears to be effective in reducing Cs-A exposure. In addition, MMF appears to significantly decrease the frequency of relapses in this patient population. Further controlled studies are warranted to better define the potential efficacy and side effects of long-term MMF therapy in this setting.en_US
dc.format.extent149574 bytes
dc.format.extent3115 bytes
dc.format.mimetypeapplication/pdf
dc.format.mimetypetext/plain
dc.language.isoen_US
dc.publisherSpringer-Verlag; IPNAen_US
dc.subject.otherSteroid-dependent Nephrotic Syndromeen_US
dc.subject.otherSteroid-resistant Nephrotic Syndromeen_US
dc.subject.otherMycophenolate Mofetilen_US
dc.subject.otherMedicineen_US
dc.subject.otherTreatmenten_US
dc.subject.otherCyclosporinen_US
dc.titleUse of mycophenolate mofetil in steroid-dependent and -resistant nephrotic syndromeen_US
dc.typeArticleen_US
dc.subject.hlbsecondlevelPublic Healthen_US
dc.subject.hlbsecondlevelPediatricsen_US
dc.subject.hlbsecondlevelInternal Medicine and Specialtiesen_US
dc.subject.hlbtoplevelHealth Sciencesen_US
dc.description.peerreviewedPeer Revieweden_US
dc.contributor.affiliationumUniversity of Michigan Health Sciences Center, Mott Children's Hospital, 1505 Simpson Road East, F6865/Box 0297, Ann Arbor, MI 48109–0297, USAen_US
dc.contributor.affiliationumUniversity of Michigan Health Sciences Center, Mott Children's Hospital, 1505 Simpson Road East, F6865/Box 0297, Ann Arbor, MI 48109–0297, USAen_US
dc.contributor.affiliationumUniversity of Michigan Health Sciences Center, Mott Children's Hospital, 1505 Simpson Road East, F6865/Box 0297, Ann Arbor, MI 48109–0297, USAen_US
dc.contributor.affiliationumUniversity of Michigan Health Sciences Center, Mott Children's Hospital, 1505 Simpson Road East, F6865/Box 0297, Ann Arbor, MI 48109–0297, USAen_US
dc.contributor.affiliationumUniversity of Michigan Health Sciences Center, Mott Children's Hospital, 1505 Simpson Road East, F6865/Box 0297, Ann Arbor, MI 48109–0297, USAen_US
dc.contributor.affiliationumcampusAnn Arboren_US
dc.identifier.pmid12774223en_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/47822/1/467_2003_Article_1175.pdfen_US
dc.identifier.doihttp://dx.doi.org/10.1007/s00467-003-1175-4en_US
dc.identifier.sourcePediatric Nephrologyen_US
dc.owningcollnameInterdisciplinary and Peer-Reviewed


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