title: Mycophenolate mofetil (MMF) treatment efficacy in children with primary and secondary glomerulonephritis.
abstract: BACKGROUND
  The aim of our study was to analyse the efficacy and safety of mycophenolate mofetil (MMF) as part of the complex immunosuppressive therapy in children with different types of primary and secondary glomerulonephritis, who were not eligible for the standard treatment routine suggested by evidence-based guidelines.
  
  
  METHODS
  The study group comprised 85 children with proteinuric glomerulopathies hospitalized between 2007 and 2010, who were non-responders to immunosuppressive therapy. The dose of MMF was established as 1 g/m(2)/24 h. Remission was defined as negative proteinuria in three consecutive urinalyses.
  
  
  RESULTS
  The patients were divided into 4 groups: idiopathic nephrotic syndrome (n = 35), primary glomerulonephritis (n = 15), auto-antibody associated glomerulonephritis (n = 20) and lupus nephropathy (LN, n = 15). Ten patients from the first group (29%) and 5 patients each from the second and third group (34% and 25% respectively) did not respond to MMF therapy. On the other hand, all the children diagnosed with LN have reached clinical and biochemical remission.
  
  
  CONCLUSIONS
  Alternative rescue MMF therapy should always be taken into consideration in proteinuric patients who are non-responders to steroids, cyclosporine A and cyclophosphamide in whom the initial glomerular filtration rate is higher than 60 ml/min/1.73m(2). It is recommended that MMF be administered as part of the standard treatment regimen in patients diagnosed with lupus nephropathy. In these groups of patients, the potent benefits of this therapy are higher than expected side-effects.
authors.affiliation: Department of Paediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poland.
authors.forename: Danuta
authors.initials: D
authors.lastname: Ostalska-Nowicka
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Malinska
authors.forename: Magdalena
authors.initials: M
authors.lastname: Silska
authors.forename: Bartlomiej
authors.initials: B
authors.lastname: Perek
authors.forename: Jacek
authors.initials: J
authors.lastname: Zachwieja
authors.forename: Michal
authors.initials: M
authors.lastname: Nowicki