Treatment of corticoid-resistant nephrotic syndrome with Sodium Mycophelonate, Enalapril and Losartan

Abstract

Introduction: Because the  steroid resistant Nephrotic Syndrome without remission evolves towards the End Stage Renal Disease. Methods: For those patients who received Steroids, Ciclophosphamida and Cyclosporin without response, we have designed a therapeutic protocol with Enteric Coated Micophenolate Sodium with Enalapril and Losartan. Using a clinical study intra-group interventionist and not randomized, during 20 months, we studied 12 patients with primary Steroid resistant Nephrotic Syndrome, with histological diagnosis of focal and segmental sclerosis. Results: The response to the Enteric Coated Micophenolate Sodium and Enalapril was considered according to: the reduction of the value of proteinuria (3 levels of responds: total, partial or absent), the renal histological damage and the mean time from the clinical diagnosis of Nephrotic syndrome to initiating the treatment with Enteric Coated Micophenolate Sodium We used a sequential scheme of treatment with a mean dose Enteric Coated Micophenolate Sodium of 650 mg/m2/día and a mean dose of Enalapril of 0.15mg/kg/dia and of Losartan of 1.2mg/Kg/day. 7 of 12 patients had partial responds to the combined treatment. The time of evolution and the degree of histological injury it influenced the therapeutic responds. Conclusion: We thought that the Enteric Coated Micophenolate Sodium added with Enalapril and Losartan are a valid alternative of treatment in patients with NSRS although probably requires in time of precocious beginning.

How to cite this article:

Liern M, De Reyes V, Vallejo G. [Treatment of corticoid-resistant nephrotic syndrome with Sodium Mycophelonate, Enalapril and Losartan]. Rev Nefrol Dial Traspl. 2009;29(2):54-9.