Mycophenolate mofetil therapy for children with steroid-resistant nephrotic syndrome

Pediatr Nephrol. 2010 May;25(5):883-8. doi: 10.1007/s00467-009-1375-7. Epub 2009 Dec 2.

Abstract

Treating children with steroid-resistant nephrotic syndrome (SRNS) has been a clinical challenge for pediatricians. We recruited 24 children (18 boys and six girls) with steroid-resistant idiopathic nephrotic syndrome (SRINS) who were <2 years. All patients were administered prednisone 2 mg/kg per day prior to mycophenolate mofetil (MMF). By the end of the eighth week, MMF was initiated at 25-30 mg/kg daily for 6- 12 months. Prednisone dose was reduced stepwise. Biochemical assays were performed every 2 months. Complete remission was achieved in 15 patients, partial remission in six, and no response to MMF was noted in three. With MMF treatment, the levels of urinary protein and serum cholesterol decreased and that of serum albumin increased in a time-dependant manner. We demonstrated the MMF could reduce proteinuria in SRINS children <2 years. Our study suggests that MMF therapy might be an effective strategy for treating SRINS in children <2 years.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child, Preschool
  • Cholesterol / blood
  • Drug Resistance*
  • Female
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use*
  • Infant
  • Male
  • Mycophenolic Acid / adverse effects
  • Mycophenolic Acid / analogs & derivatives*
  • Mycophenolic Acid / therapeutic use
  • Nephrotic Syndrome / complications
  • Nephrotic Syndrome / drug therapy*
  • Prednisone / therapeutic use*
  • Prospective Studies
  • Proteinuria / drug therapy
  • Proteinuria / etiology
  • Remission Induction
  • Serum Albumin / metabolism
  • Steroids / therapeutic use*
  • Time Factors
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • Serum Albumin
  • Steroids
  • Cholesterol
  • Mycophenolic Acid
  • Prednisone