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Immunosuppressive Treatment of Membranoproliferative Glomerulonephritis
- Source :
- Scopus-Elsevier
- Publication Year :
- 1994
- Publisher :
- S. Karger AG, 1994.
-
Abstract
- The treatment of membranoproliferative glomerulonephritis (MPGN) is considered by most authors as unrewarding, and the disease progresses to end-stage renal disease (ESRD). We studied the effectiveness of a new immunosuppressive (IS) regimen by analyzing the rates of remission, relapse and progression to ESRD in 19 patients with MPGN. The treatment consisted of 4 phases: (1) induction with intravenous boluses of methylprednisolone plus cyclophosphamide (CPM) orally; (2) maintenance with oral prednisone (PDN) in an alternate-day regimen and CPM in a daily oral dose; (3) tapering during which PDN alone was slowly decreased; (4) discontinuation when CPM was omitted and PDN slowly withdrawn according to the steroid withdrawal schedule. At the end of the treatment that lasted on average 10 +/- 1 months, 15 patients remitted, 3 improved and 1 progressed. There were 8 relapses in 6 patients: 4 in 3 patients were treated with repeat cycles and remitted completely. Four patients who had relapsed after 4, 8, 11 and 13 years of remission refused retreatment and progressed rapidly to ESRD. All patients treated and retreated after relapsing had remissions, while renal failure and disease progression occurred in 1 patient only. Plasma creatinine averaged, in the whole group, 165 +/- 26 before, 156 +/- 30 after treatment and 224 +/- 57 microM/l at the end of 7.4 +/- 0.8 years of follow-up. An intensive IS regimen combining steroids and alkylating agents in high doses and for a prolonged time is effective in inducing remission and halting progression to ESRD in patients with MPGN.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Cyclophosphamide
Glomerulonephritis, Membranoproliferative
medicine.medical_treatment
Methylprednisolone
Gastroenterology
Drug Administration Schedule
Prednisone
Internal medicine
Membranoproliferative glomerulonephritis
medicine
Humans
Child
Aged
Chemotherapy
business.industry
Middle Aged
medicine.disease
Discontinuation
Regimen
Creatinine
Immunology
Kidney Failure, Chronic
Mesangial proliferative glomerulonephritis
Drug Therapy, Combination
Female
business
Immunosuppressive Agents
medicine.drug
Subjects
Details
- ISSN :
- 22353186 and 16608151
- Volume :
- 67
- Database :
- OpenAIRE
- Journal :
- Nephron
- Accession number :
- edsair.doi.dedup.....00cae7df16733bb34f2bf3c34a9547b0