title: Mycophenolate mofetil alleviates persistent proteinuria in IgA nephropathy.
abstract: BACKGROUND
  Mycophenolate mofetil (MMF) is increasingly used to treat primary glomerulopathies. Its effectiveness in IgA nephropathy (IgAN) remains unclear.
  
  
  METHODS
  Forty IgAN patients with persistent proteinuria (>1 g/24 hours) despite conventional treatment with blockers of the renin-angiotensin system were randomized to receive MMF for 24 weeks (group 1) or continue conventional therapy (group 2), and followed for 72 weeks. The primary end point was reduction of proteinuria by 50% or more over entry level.
  
  
  RESULTS
  Sixteen patients (80%) in group 1 versus six patients (30%) in group 2 reached the primary end point (P= 0.0019). Time-averaged change in proteinuria showed a significant decline in group 1, while control subjects displayed a modest rise (P= 0.003). By 72 weeks, the mean proteinuria was 62.0 +/- 7.7% (P= 0.003) and 120.5 +/- 14.1% (P= 0.351) that of the corresponding baseline value in group 1 and group 2, respectively. There was concomitant increase in serum albumin and decrease in serum IgA levels in group 1 but not group 2 patients. Baseline histologic grades, blood pressure control, and the rates of change in serum creatinine and creatinine clearance were not different between the two groups. Normalization in binding of polymeric IgA to cultured mesangial cells and serum interleukin-6 (IL-6) levels, which sustained to study end, was observed in group 1 but not group 2 subjects.
  
  
  CONCLUSIONS
  In selected patients with IgAN, MMF is effective in lowering proteinuria and ameliorating some of the putative pathogenetic abnormalities.
authors: Nephrology Division, Department of Medicine, University of Hong Kong and Queen Mary Hospital, Hong Kong, China.
authors: Sydney
authors: S
authors: Tang
authors: Joseph C K
authors: JC
authors: Leung
authors: Loretta Y Y
authors: LY
authors: Chan
authors: Yun Hoi
authors: YH
authors: Lui
authors: Colin S O
authors: CS
authors: Tang
authors: Chi Hang
authors: CH
authors: Kan
authors: Yiu Wing
authors: YW
authors: Ho
authors: Kar Neng
authors: KN
authors: Lai
mesh_terms: D000328:Adult; D001794:Blood Pressure; D005260:Female; D005922:Glomerulonephritis, IGA / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D011507:Proteinuria / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology; D012964:Sodium / Q000652:urine; D016896:Treatment Outcome
chemical_list: D007070:Immunoglobulin A; D007166:Immunosuppressive Agents; D012964:Sodium; D009173:Mycophenolic Acid