Mechanisms of Resistance to Immunosuppressive Therapy in Patients With Nephrotic Syndrome

Idiopathic nephrotic syndrome is the most common glomerular disease in children, with a prevalence of 1.15–16.9 cases per 100,000 children per year worldwide. In some cases, nephrotic syndrome has a frequently relapsing course or dependence on steroid therapy is formed, which leads to the appointment of immunosuppressive therapy. So far, in clinical practice, there is no unambiguous approach among physicians to the management of patients with nephrotic syndrome, especially when it comes to the further choice of immunosuppressive therapy. Because of the serious side effects of long-term corticosteroid use, doctors prescribe steroid adjuvants to maintain remission and limit the cumulative effect of glucocorticosteroids. Among adjuvants, mycophenolate mofetil, with mycophenolic acid as the active ingredient, is believed to be the most preferred option due to fewer adverse events, acceptable tolerability and, at the same time, high efficacy. This article describes the advantages and features of the use of mycophenolic acid in clinical practice, provides data on pharmacodynamics and drug monitoring, and discusses issues of personalized medicine.

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Mycophenolate mofetil in therapy of primary nephrotic syndrome in children

KURSOVA

Petrosyan

Piruzieva

et al. 2023

Ross. vestn. perinatol. pediatr.

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Disorders of club filtration barrier as the cause of proteinuria in the nephrotic syndrome

Zverev

Rykunova

2019

Nefrologiâ (St.-Peterbg.)

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Risk factors for developing renal amyloidosis

Rakhmanova¹,

Рахманов²,

Летифов³

2022

General Physician

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As a result of the literature review carried out by the authors, it was revealed that the pathogenesis of autoimmune diathesis, rheumatoid arthritis and rheumatoid nephritis in children has a general immunopathological nature. However, autoimmune diathesis is an important risk factor for the onset and progression of rheumatoid arthritis and the subsequent development of renal amyloidosis based on immunopathological reactions in these patients.

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Mechanisms of Resistance to Immunosuppressive Therapy in Patients With Nephrotic Syndrome

Cited by 3 publications

References 24 publications

Mycophenolate mofetil in therapy of primary nephrotic syndrome in children

Mycophenolate mofetil in therapy of primary nephrotic syndrome in children

Disorders of club filtration barrier as the cause of proteinuria in the nephrotic syndrome

Risk factors for developing renal amyloidosis

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