Clinical Observation Of Mycophenolate Mofetil In The Treatment Of Chronic Renal Insufficiency With Proteinuria

Objective: The progression of chronic renal failure (CRF) remains one of the main challenges in clinical nephrology.Chronic renal failure is characterized by a persistently abnormal glomerular filtration rate. Although the causes and the locations of renal insult may vary, many features are common in progression to renal failure, and the final histological picture is one of glomerulosclerosis, interstitial fibrosis and loss of renal cells, mainly by apoptosis. Possible mechanisms of progressive renal damage include hemodynamic factors, hypertension, proteinuria, angiotensin II, and other chemical mediators such as cytokines and growth factors. Most progressive renal diseases are accompanied by proteinuria. In general, the greater the proteinuria, the more likely the disease will progress.Recent studies suggest that the proteinuria itself may contribute to the pathologic injury and is a independent risk factor for renal damage. Glomerular injury results in increased permeability of the glomerular basement membrane for plasma proteins, some of which are ingested by proximal tubular cells. When proximal tubular cells ingest filtered protein, an inflammatory response is initiated, which contributes to the interstitial scarring. Tubulointerstitial fibrosis is a morphologic hallmark of chronic, progressive renal disease and is thought to be the final common mechanism leading to end-stage renal disease. Of particular clinical relevance, the rate of decline of the glomerular filtration rate in patients with chronic renal disease correlates strongly with the extent of tubulointerstitial injury ,In...