Journal Article

Treatment of idiopathic membranoproliferative glomerulonephritis with mycophenolate mofetil and steroids

Gareth Jones, Maciej Juszczak, Edward Kingdon, Mark Harber, Paul Sweny and Aine Burns

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 19, issue 12, pages 3160-3164
Published in print December 2004 | ISSN: 0931-0509
Published online October 2004 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfh526
Treatment of idiopathic membranoproliferative glomerulonephritis with mycophenolate mofetil and steroids

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Background. Treatment of adults with idiopathic membranoproliferative glomerulonephritis (IMPGN) is often unrewarding with ∼60% of patients progressing to end-stage renal failure within 10 years. Although children with IMPGN may respond to steroid therapy, there is no significant benefit to treating adult IMPGN patients with immunosuppression.

Methods. Outcome measures in five patients with IMPGN who were treated with oral prednisolone and mycophenolate mofetil (MMF) (treatment group) were compared with six patients with IMPGN who did not receive immunosuppression (control group).

Results. There was no significant difference between either group in baseline clinical characteristics or systolic and diastolic blood pressure during observation. In the treatment group, there was a significant reduction in proteinuria from a baseline of 5.09 to 1.97 g/24 h (P = 0.003) at 6 months, 1.96 g/24 h (P = 0.003) at 12 months and 2.59 g/24 h (P = 0.015) at 18 months. There was no significant change in proteinuria over 18 months in the control group. Serum creatinine concentration and creatinine clearance did not change significantly over 18 months in the treatment group. In the control group, there were significant changes in serum creatinine and creatinine clearance over 18 months [baseline 103 to 159 µmol/l (P = 0.004) and baseline 108 to 67 ml/min (P>0.001), respectively] when compared to baseline, although the differences were not significant when the two groups were compared directly.

Conclusions. This preliminary study suggests that in the short term, the combination of MMF and prednisolone can significantly reduce proteinuria and may preserve renal function in patients with IMPGN.

Keywords: membranoproliferative glomerulonephritis; mycophenolate mofetil; proteinuria

Journal Article.  2706 words.  Illustrated.

Subjects: Nephrology

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