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Mycophenolate mofetil therapy for children with steroid-resistant nephrotic syndrome

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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.

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Acknowledgement

This work was supported by the State of Health Science Foundation of Hunan province (B2005149), State of Science and Technology Science Foundation of Hunan province (06SK3198), State Administration of Traditional Chinese Medicine of Hunan province (6301) in China. The authors thank all colleagues who took medical records, managed patients, did renal biopsies, and assisted with follow-up.

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Authors and Affiliations

  1. Department of Nephrology, Hunan Children’s Hospital, 82 Ziyuan Road, Changsha, Hunan, 410007, People’s Republic of China

    Zhihui Li, Cuirong Duan, Jinhua He, Tianhui Wu, Mai Xun, Yi Zhang & Yan Yin

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  1. Zhihui Li
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  2. Cuirong Duan
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  3. Jinhua He
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  4. Tianhui Wu
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Correspondence to Zhihui Li.

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Li, Z., Duan, C., He, J. et al. Mycophenolate mofetil therapy for children with steroid-resistant nephrotic syndrome. Pediatr Nephrol 25, 883–888 (2010). https://doi.org/10.1007/s00467-009-1375-7

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  • DOI: https://doi.org/10.1007/s00467-009-1375-7

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