observation on curative effect of mycophenolate mofetil on frequently relapse nephrotic syndrome in children
1.Department of Renal Medicine, the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027; 2.Department of Respiration Medicine, the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027
Abstract：Objective: To observe and evaluate the efficacy and safety of mycophenolate mofetil (MMF) on frequently relapse nephrotic syndrome (FRNS) in children. Methods: Thirty-five patients with FRNS were chosen for observation. Prednisolone was administered 2.0 mg/kg per day and reduced gradually after remission. MMF 20～40 mg/kg daily in two divided doses after relapse was therefore commenced and this treatment continued for at least 6 months. MMF was abandoned if proved ineffective or continued with a gradually reducing dose if not. Urinalysis, complete blood counts, biochemistry and adverse effects were supervised during the treatmeant. Results: Mean 6-monthly relapse rates decreased significantly from 3.34 (2.49, 5.50) episodes before MMF therapy to 0.00 (0.00, 1.00) episodes in the first 6 months in 33 patients (P<0.001), from 3.14 (2.40, 5.00)episodes before MMF therapy to 0.00 (0.00, 1.00) episodes in the next 6 months in 30 patients (P<0.001), from 3.34 (2.57, 6.00) episodes before MMF therapy to 1.00 (0.00, 1.20) episodes in 13th-18th month in 23 patients (P<0.001), and from 3.34 (2.49, 6.00) episodes before MMF therapy to 0.60 (0.00, 1.05) episodes in 17 patients who followed-up for more than 18 months. Prednisolone dosage was tapering during the treatment (P<0.001). Adverse effects observed were as the following: one patient had transient abdominal pain, one had got acute appendicitis, two had more cold than usual, one got urinary tract infection and one had a muscle tremor phenomena. No patients were found suffering from hematological abnormalities, impaired renal or hepatic function. Conclusion: MMF is an effective and safe immunosuppressant for children with FRNS.
