Mycophenolate mofetil in the treatment of steroid-resistant primary focal segmental glomerulosclerosis

We report our experience in using mycophenolate mofetil (MMF) for the treatment of steroid-resistant focal segmental glomerulosclerosis (FSGS) in two patients. Patient 1, who was treated on disease presentation, responded well with sustained complete remission. Patient 2, who had unsuccessful steroid treatment 4 yrs before and was re-treated with MMF, showed transient retardation in renal disease progression but eventually progressed to end-stage renal failure. Our observation illustrates that MMF could be useful in treating steroid-resistant FSGS if administered at an early phase of the disease, well before histologic damage becomes irreversible. Its efficacy requires validation in randomized, controlled trials. The current armamentaria for the treatment of this condition are also discussed.