| 'Rescue Therapy' with Mycophenolate Mofetil in Non-transplant Renal Disease Patients Experienced Conventional Immunosuppressive Treatments : Clinical Observation |
| Byeong Yun Yang, M.D., Jin Kang, M.D., Sang Heon Song, M.D. Dong Won Lee, M.D. and Ihm Soo Kwak, M.D. |
| Division of Nephrology, Department of Internal Medicine, College of Medicine Pusan National University, Busan, Korea |
| 원저 : 기존의 면역 억제 치료를 경험한 비이식 신질환 환자에서 Mycophenolate Mofetil을 이용한 구제요법 |
| 양병윤•강 진•송상헌•이동원•곽임수 |
| 부산대학교 의과대학 내과학교실, 신장내과 |
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| Abstract |
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Purpose : Mycophenolate mofetil (MMF) is thought to have not only low frequency of adverse side effects but also have equal efficacy to other conventional immunosuppressants (CIS). But It's hard to conclude that CIS may be replaceable with MMF. So we inquired into another aspect of MMF as 'Rescue therapy' in non-transplant renal diseases.
Methods : Twenty nine patients with non-transplant renal diseases received MMF therapy between January 2000 and April 2007. Eighteen patients who had received MMF more than 6 months were included. Sixteen of the 18 patients included were resistant to CIS and two were patients who maintained complete remission (CR) with MMF because of the adverse side effects of CIS. Treatment outcome was evaluated by dip-stick urine test. CR was defined by negative or trace, partial remission (PR) by 1 positive and treatment failure (TF) by more than 1 positive.
Results : Eleven of the resistant 16 patients had shown CR (69%) and maintained CR. Two of maintenance therapy with MMF had kept CR more than 12 months. The proportions of the patients who had shown decreased proteinuria in each treatment duration were 69% for 3 months (p=0.005), 81% for 6 months (p=0.001), 86% for 9 months (p=0.002) and 91% for 12 months (p=0.004), respectively. There were few adverse effects.
Conclusion : We observed the efficacy of MMF in decreasing proteinuria and maintaining CR as 'Rescue therapy' for previously treated non-transplant renal disease patients with CIS. Large controlled clinical trials are expected for defining this effect.
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| Key Words:
Mycophenolate mofetil, Kidney diseases, Proteinuria |
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