Outcome of therapy with mycophenolate mofetil in membranoproliferative glomerulonephritis in pediatric age group

Background: membranoproliferative glomerulonephritis (mpgn) is an uncommon glomerulopathy in pediatric age group which progresses gradually to chronic kidney disease (ckd) despite long-term treatment with corticosteroids. aim: to determine the efficacy of mycophenolate mofetil (mmf) in patients of biopsy-proven mpgn regarding (1) maintenance of remission and (2) delay in progression to ckd. methods: a prospective,interventional case-control study was carried out on forty children with idiopathic mpgn who received steroids with and without mmf. the follow-up was done for > 3 years for every child during which the drugs were tapered in case of complete remission and discontinued if failure of response occurred after 3 months of therapy. results: the serum creatinine was normal in group a (steroids alone) and deranged at the time of presentation in group b (steroids+mmf) with a mean value of 0.91±0.42 and 1.07±0.49mg/dl respectively. among group a patients 55% achieved complete and sustained remission for >3 years as compared to 60% children in group b,while partial remission was seen in 25% and 30% respectively. ckd was found to develop in 40% children in group a and 25% patients in group b. conclusion: the response to mmf in combination with steroids was found to be better than steroids alone in terms of achieving and maintaining remission with less progression to ckd in biopsy-proven patients of mpgn. however,the study was underpowered to show statistical significance.