Mycophenolate Mofetil as a Rescue Therapy in Frequently Relapsing/Steroid-Dependent Nephrotic Syndrome in Children; Ability to Maintain Remission

Introduction. Nephrologists usually encounter therapeutic challenges and dilemmas when treating steroid-dependent nephrotic syndrome (SDNS) and frequently relapsing nephrotic syndrome (FRNS). Due to the serious side effects of long-term administration of corticosteroids, physicians administer steroid adjuvants to maintain remission and to limit the cumulative dosage of corticosteroids. Among these adjuvants, it is postulated that mycophenolate mofetil (MMF) is an impressive option owing to its fewer side effects, acceptable tolerance, and high effectiveness. Methods. This comparative study was performed on a group of SD/FRNS patients who were on MMF therapy for an average duration of 2.75 years and on regular follow-up at the Department of Nephrology of Imam Reza Hospital, Kermanshah, Iran. Results. A total of 32 patients with a male to female ratio of 1.2:1 were enrolled. The mean duration of follow-up prior to and following the initiation of MMF therapy was 2.63 and 2.75 years, respectively. The results obtained from the comparative analysis of the recurrence rate and the dose of corticosteroids used prior to and following the initiation of MMF therapy revealed that this therapy significantly lowered the recurrence rate (P < .05) and the corticosteroid dose (P < .05). Hence MMF is a well-tolerated and effective agent in decreasing the recurrence rate (64.52%) and the cumulative dosage of corticosteroid (43.88%) in complicated nephrotic syndrome patients. Conclusion. There were no significant differences between the patients treated with MMF as the first steroid-sparing agent and those treated with MMF as the second or third agents.