Use of mycophenolate mofetil in resistant membranous nephropathy

被引:119
作者
Miller, G [1 ]
Zimmerman, R [1 ]
Radhakrishnan, J [1 ]
Appel, G [1 ]
机构
[1] Columbia Univ, Coll Phys & Surg, Dept Med, Div Nephrol, New York, NY USA
关键词
mycophenolate mofetil (MMF); idiopathic membranous nephropathy (MN); proteinuria; nephrotic; high risk;
D O I
10.1053/ajkd.2000.8968
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Membranous nephropathy (MN) is a common cause of nephrotic syndrome. Optimal therapy for this disease is still debated. We report our experience using mycophenolate mofetil (MMF), an immunosuppressive agent widely used in transplant recipients, to treat 16 nephrotic patients with MN. AII patients had biopsy-documented MN; secondary forms were ruled out. Fifteen patients had steroid-resistant disease; cytotoxic agents had failed in 6 patients and cyclosporine therapy had failed in 5 patients. Patients were treated with MMF (dose range, 500 to 2,000 mg) for a mean of 8 months. Six patients experienced a halving of proteinuria, which occurred after a mean duration of 6 months of therapy. Partial remissions occurred in 2 patients. There were no significant changes in mean values for serum creatinine, serum albumin, or proteinuria. Mean cholesterol levels were significantly less. Side effects of MMF were infrequent and generally mild. In summary, MMF appears to reduce proteinuria in some patients with idiopathic MN previously resistant to steroids, cytotoxic agents, or cyclosporine. Further trials with this agent are warranted. (C) 2000 by the National Kidney Foundation, inc.
引用
收藏
页码:250 / 256
页数:7
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