title: Clinical experience of mycophenolate mofetil in the treatment of chronic allograft nephropathy in kidney transplantation: three-year follow-up.
abstract: BACKGROUND
  Mycophenolate mofetil (MMF) in conjunction with calcineura antagonists has been shown to prevent acute rejection in renal allograft recipients. Its role in treatment of chronic rejection or allograft nephropathy is still controversial. We initiated the study to investigate the effect of adding MMF to a cyclosporine plus prednisolone regimen in renal recipients with chronic allograft nephropathy.
  
  
  METHODS
  We retrospectively studied 36 patients with chronic allograft nephropathy, defined clinically as increased of serum creatinine, proteinuria, and hypertension. Renal function, cyclosporine level, renal biopsy, and renal scan were regularly done as indicated. MMF was added to 20 recipients after initial treatment with cyclosporine and prednisolone. The other 16 recipients were managed without adding MMF. Serum creatinine was monitored for 3 years.
  
  
  RESULTS
  The demographic characteristics of the patients in the two groups were comparable. The average dose of prednisolone was unchanged throughout the study and the trough level of cyclosporine was maintained in the range of 100 to 150 ng/mL. The serum creatinine decreased initially in the group on MMF, but renal function deteriorated progressively after 6 months. There was a difference in serum creatinine between the two groups but this did not reach statistical significance.
  
  
  CONCLUSIONS
  MMF therapy tender to improve renal function initially but did not attenuate significantly the impairment in chronic allograft nephropathy.
authors.affiliation: Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan.
authors.forename: S-H
authors.initials: SH
authors.lastname: Chu
authors.forename: C-T
authors.initials: CT
authors.lastname: Wu
authors.forename: C-C
authors.initials: CC
authors.lastname: Chou
authors.forename: Y
authors.initials: Y
authors.lastname: Chen
authors.forename: K-L
authors.initials: KL
authors.lastname: Liu
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Chiang
mesh_terms: D003404:Creatinine / Q000097:blood; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology* / Q000473:pathology*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D011239:Prednisolone / Q000627:therapeutic use; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents; D011239:Prednisolone; D003404:Creatinine; D009173:Mycophenolic Acid