Mycophenolate Mofetil Treatment in Primary Glomerular Disease: One-Year Follow-Up in Steroid Dependent and Resistant Nephrotic Syndrome
Adis Tasanarong MD*, Supachai Thitiarchakul MD*
Affiliation : * Nephrology Division, Faculty of Medicine, Thammasat University
Objective : Treatment of primary nephrotic syndrome (NS) with steroid and cyclophosphamide may be unsuc-
cessful and have much toxicity. Therefore, the authors evaluated the outcome of mycophenolate mofetil (MMF)
treatment in these patients.
Materials and Methods : Fourteen primary NS patients who had failure to steroid and/or cyclophosphamide
therapy were treated by MMF for at least 3 months as alternative treatment. Median + SD (range) of urine
protein to creatinine index (UPCI), serum albumin, serum creatinine, serum cholesterol and dose of predniso-
lone at the start, 1mo, 3 mo, 6mo, and 12 mo after MMF therapy were compared.
Results : In the study group, the mean of UPCI decreased significantly from 2.79 + 8.1 to 1.81 + 1.54 (p = 0.02)
at 12 months after the MMF therapy with no significant change in the mean serum creatinine from 1.14 + 0.45
to 1.27 + 0.67 mg/dL. The mean serum albumin increased significantly from 2.87 + 0.56 to 3.46 + 0.76 g/dL
(p = 0.05) and the mean of prednisolone dosage decreased significantly from 34.64 + 19.16 to 11.11 + 8.58
mg/day (p = 0.004). For patients with IgM Nephropathy (IgMN), one of three steroid dependent patients
presented with improved renal function. One of two patients with focal segmental glomerulosclerosis (FSGS)
had a complete remission and one of two patients with IgA nephropathy (IgAN) had improved renal function
with partial remission.
Conclusion : MMF therapy in NS patients with primary glomerular disease was well tolerated and safe. These
efficacies can improve NS, stabilize renal function, and achieve steroid withdrawal.
Keywords : Steroid dependent and resistant nephrotic syndrome, Mycophenolate mofetil, primary glomerular disease
