Renal function evolution during idiopathic
nephrotic syndrome depends on treatment toxicity.
Cyclosporin is effective as a
steroid-sparing agent but patients are dependant on this
drug, which can lead to renal toxicity.
Mycophenolate mofetil, a widely used
drug in
organ transplantation, has short-term beneficial effects in glomerular diseases, including idiopathic
nephrotic syndrome. Little is known about
mycophenolate mofetil in children and long-term evolution. We analysed a cohort of 12 children with
steroid-dependant
nephrotic syndrome due to
minimal change disease in remission with
cyclosporine therapy. They were switched to
mycophenolate mofetil, when renal toxicity was diagnosed. We evaluated the number of relapses, tolerance of this new treatment, renal function and body mass index under mycophenolate. After a follow-up of 31.25 months,
mycophenolate mofetil alone was effective in preventing relapses in eight patients, without side effects. Renal function significantly improved and the final body mass index decreased. Three patients relapsed on discontinuation of
mycophenolate mofetil. The results suggest that
mycophenolate mofetil is effective and safe in preventing relapses in
steroid-dependant
nephrotic syndrome. Furthermore, switching from
cyclosporine to
mycophenolate mofetil restores renal function. Therefore,
mycophenolate mofetil might be considered as an alternative to
cyclosporine, to preserve renal function and spare
steroids during idiopathic
nephrotic syndrome in children.