Use of mycophenolate mofetil in steroid-dependent and -resistant nephrotic syndrome
dc.contributor.author | Barletta, Gina-Marie | en_US |
dc.contributor.author | Bunchman, Timothy E. | en_US |
dc.contributor.author | Flynn, Joseph T. | en_US |
dc.contributor.author | Kershaw, David B. | en_US |
dc.contributor.author | Smoyer, William E. | en_US |
dc.date.accessioned | 2006-09-11T19:25:57Z | |
dc.date.available | 2006-09-11T19:25:57Z | |
dc.date.issued | 2003-08 | en_US |
dc.identifier.citation | Barletta, 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.issn | 1432-198X | en_US |
dc.identifier.issn | 0931-041X | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/47822 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=12774223&dopt=citation | en_US |
dc.description.abstract | Cyclosporin (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.extent | 149574 bytes | |
dc.format.extent | 3115 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.language.iso | en_US | |
dc.publisher | Springer-Verlag; IPNA | en_US |
dc.subject.other | Steroid-dependent Nephrotic Syndrome | en_US |
dc.subject.other | Steroid-resistant Nephrotic Syndrome | en_US |
dc.subject.other | Mycophenolate Mofetil | en_US |
dc.subject.other | Medicine | en_US |
dc.subject.other | Treatment | en_US |
dc.subject.other | Cyclosporin | en_US |
dc.title | Use of mycophenolate mofetil in steroid-dependent and -resistant nephrotic syndrome | en_US |
dc.type | Article | en_US |
dc.subject.hlbsecondlevel | Public Health | en_US |
dc.subject.hlbsecondlevel | Pediatrics | en_US |
dc.subject.hlbsecondlevel | Internal Medicine and Specialties | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | University of Michigan Health Sciences Center, Mott Children's Hospital, 1505 Simpson Road East, F6865/Box 0297, Ann Arbor, MI 48109–0297, USA | en_US |
dc.contributor.affiliationum | University of Michigan Health Sciences Center, Mott Children's Hospital, 1505 Simpson Road East, F6865/Box 0297, Ann Arbor, MI 48109–0297, USA | en_US |
dc.contributor.affiliationum | University of Michigan Health Sciences Center, Mott Children's Hospital, 1505 Simpson Road East, F6865/Box 0297, Ann Arbor, MI 48109–0297, USA | en_US |
dc.contributor.affiliationum | University of Michigan Health Sciences Center, Mott Children's Hospital, 1505 Simpson Road East, F6865/Box 0297, Ann Arbor, MI 48109–0297, USA | en_US |
dc.contributor.affiliationum | University of Michigan Health Sciences Center, Mott Children's Hospital, 1505 Simpson Road East, F6865/Box 0297, Ann Arbor, MI 48109–0297, USA | en_US |
dc.contributor.affiliationumcampus | Ann Arbor | en_US |
dc.identifier.pmid | 12774223 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/47822/1/467_2003_Article_1175.pdf | en_US |
dc.identifier.doi | http://dx.doi.org/10.1007/s00467-003-1175-4 | en_US |
dc.identifier.source | Pediatric Nephrology | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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