ABSTRACT
AIM: To study the effect of mycophenolate mofetil (Cell Cept) in treating patients with various types of chronic glomerulonephritis and other immune nephropathies. MATERIAL AND METHODS: Between 2000 and 2003 we treated 35 patients (18 women, 17 men) with Cell Cept (La Roche). In 32 patients the diagnosis was confirmed by kidney biopsy (immunofluorescence, light and electron microscopy). RESULTS: Treatment with Cell Cept was very successful in 22 of the patients in the study (62.86%). Proteinuria was significantly reduced and firmly maintained well below 0.5 g/l; serum protein levels were elevated to normal values, the edemas disappeared. In 12 patients the drug had a good effect: there was a significant reduction of proteins in the urea within 1.2 - 2.0 g/l, an increase of total protein and albumins in plasma but after three months of treatment. The therapy was with no effect only in one patient with primary amyloidosis of kidneys. CONCLUSIONS: Treatment with mycophenolate mofetil (Cell Cept) is an alternative modality for the management of immune glomerulopathies resistant to conventional and pulse pathogenetic therapeutic regimens. It can be a treatment of first choice.
Subject(s)
Glomerulonephritis/drug therapy , Immunosuppressive Agents/therapeutic use , Mycophenolic Acid/analogs & derivatives , Mycophenolic Acid/therapeutic use , Adult , Drug Therapy, Combination , Female , Glomerulonephritis/immunology , Glomerulonephritis/pathology , Humans , Kidney/pathology , Male , Microscopy, Fluorescence , Prednisolone/therapeutic use , Proteinuria/drug therapy , Treatment OutcomeABSTRACT
We conducted a ten-year clinical and ultrasound follow-up study of 120 siblings with ADPKD (68 men and 52 women, aged 19-40). 40 subjects had polycystic kidney disease. During the study period, the number and size of the cysts increased. Symptoms and signs also changed: at baseline 51% of the subjects were asymptomatic dropping subsequently to 2%. Initially, 32 subjects had 1-5 cysts in one or both kidneys and they were classified as suspected of having ADPKD. Significant changes were found in this group at the end of the follow-up. In 12 of them (37.50%) subsequent ultrasonograms revealed an increase in the number and size of the cysts--i.e. evolution towards ADPKD. None of the subjects in this group had a decrease in the number of cysts. In the control group, three had multiple cysts but most subjects were ultrasonographically negative for polycystic kidney disease. In conclusion, the authors recommend a clinical and ultrasonographic long-term follow-up of subjects at risk for ADPKD which should allow early diagnosis as well as prevention of the complications which result in chronic renal failure.
