Mikofenolat Mofetil sebagai Terapi Sindrom Nefrotik Relaps Sering dan Resisten Steroid pada Anak
Sari
Abstrak. Sindrom nefrotik relaps sering, sindrom nefrotik dependen steroid, dan sindrom nefrotik resisten
steroid pada anak merupakan sindrom nefrotik yang sulit diobati. Hasil pengobatan dengan imunosupresan
seperti siklofosfamid, klorambusil, levamisol, atau siklosporin-A yang diberikan secara oral maupun intravena
sering kurang memuaskan. Mikofenolat mofetil (MMF) merupakan imunosupresan yang menghambat
enzim inosine monophosphate dehydrogenase, bekerja secara selektif, tidak kompetitif, dan reversibel.
Preparat MMF telah digunakan dalam tata laksana penyakit ginjal. Pada sindrom nefrotik relaps seringdependen
steroid, MMF dapat menyebabkan penurunan mean relapse rate dari 4,1 menjadi 1,3 relaps per
tahun, menyebabkan remisi total dengan perbaikan fungsi ginjal, dan mempertahankan keadaan remisi.
Pada sindrom nefrotik resisten steroid, MMF dapat menyebabkan dan frekuensi perawatan menurun remisi
total dan mengubah keadaan sindrom nefrotik resisten steroid menjadi responsif steroid. Preparat MMF
dapat digunakan sebagai monoterapi atau kombinasi dengan imunosupresan lain pada anak dengan sindrom
nefrotik bermasalah. Terbukti MMF dapat menyebabkan remisi total, mengubah keadaan resisten steroid
menjadi responsif steroid, dan menurunkan kejadian relaps
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DOI: http://dx.doi.org/10.14238/sp9.1.2007.23-31
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