Punit Gupta
Pt. Jawaharlal Nehru Memorial Medical College, Raipur
Title: “Role of Mycophenolate Mofetil and Deflazacort in Treatment of patients under Nephrotic Syndrome. A study from Tribal Area of Developing country(India)
Biography
Biography: Punit Gupta
Abstract
Introduction: The literature on the clinical effectiveness of treatments for steroids resistance nephritic syndrome is very limited.mycophenolate mofetil represents a promising therapeutic alternative without nephrotoxicity. Deflazacort is a newer glucocorticoid which not only have similar efficacy but also lower incidence of side effects compared to prednisolone. Those patients who are not responds to Deflazacort monotherapy given Mycophenolate mofetil & these patients shows the drastic improvement with minimal relapse of the disease. This study is In order to assess whether Deflazacort &Mycophenolate mofetil adjuvant therapy can replace the traditional treatment of the nephrotic syndrome.
Method: The study was conducted in the Department of Medicine, Pt. J.N.M. Medical College and Dr. B.R.A.M.Hospital, Raipur. 55 patients of Nephrotic Syndrome were included for the purpose of study admitted in Nephrology Unit, Pt.J.N.M.Medical College Raipur from was studied. All patients were subjected to routine investigations, Thyroid Function Test, CBC etc.
Results:
- Total no of patients included in study are 55.
- Mean age of the patient is 28.25±13.03 years.
- 66.66%patients are Male while 33.33% patients are female.
- Number of patient Steroid Dependent Nephrotic Syndrome patient are 25%
- Number of patient Steroid Resistant Nephrotic Syndrome patient are 75%
- 95.83% patients having Hypoalbuminea.
- 41.66% patients are Hypothyroid out of them 70% was male & 30 % was female.
- 95.83% patients shows electrolyte imbalance.
- 91.66% patients shows abnormal usg findings in which increased Echotexture, Ascites, Plural Effusion & Follicular Cyst seen in 62.5%, 45.83%, 41.66% & 8.31% respectively.
- Average weight of the Nephrotic Syndrome patient is 51.33±16.31kg
- Dose of Deflazacort used is 1 mg/kg body weight.
- Dose of Mycophenolate mofetil used is 12mg/kg body weight.
- Average weight reduction in week duration is 8.083±3.88 kg
- 12 % patient developed complication of nephrotic syndrome specially DVT.
- Only 4 patients shows complication of mycophenolate mofetil in the form of loose stool and low WBC count .
- 96% patients shows improvement in 6 month follow up & only 1 patient had relapse because of irregular medication.
Conclusion:
- Male shows greater improvement than female.
- Maximum weight reduction was from 96 kg to 54 kg at the time of discharge
- Hypoalbuminemia and hypothyroidism was common in male than female.
- Loose stool and low WBC count as common complication with Mycophenolate mofetil.
- 96% patients shows improvement with Deflazacort &Mycophenolate mofetil.