Methylprednisolone pulse therapy in rapidly progressive glomerulonephritis.
Twenty-five patients with rapidly progressive glomerulonephritis (RPGN) were treated with methylprednisolone (MP) pulse therapy (1 g intravenously on 3 successive days). In all patients renal biopsy was done before or just after the start of therapy. Pulse therapy was used in all patients in combination with a low oral maintenance dose of prednisone. In 21 patients additional immunosuppressive treatment was given, either cyclophosphamide (n = 19) or azathioprine (n = 2); in 2 patients plasmapheresis was also applied. Sixteen of the 25 patients were dialysis-dependent at presentation; 11 of them improved, an additional 3 had a temporary recovery, but needed maintenance renal replacement therapy after 5-46 months, mean 22 months. Nine of the 25 patients were not dialysis-dependent, 6 of them improved, an additional one had a temporary recovery, but needed chronic dialysis after 35 months. When many irreversible glomerular lesions were present, the effectiveness of MP pulse therapy was limited or only of a temporary character. Serious side effects did not occur. In conclusion MP pulse therapy is a successful treatment with minimal adverse reactions in patients with RPGN and active histological lesions.
de Glas-Vos
J W
JW
Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Krediet
R T
RT
Arisz
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005921:Glomerulonephritis / Q000188:drug therapy*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D012189:Retrospective Studies
D011241:Prednisone; D008775:Methylprednisolone