RESPONSE OF TYPE-I MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS TO PULSE METHYLPREDNISOLONE AND ALTERNATE-DAY PREDNISONE THERAPY

被引：25

作者：

BERGSTEIN, JM

ANDREOLI, SP

机构：

[1] Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana

来源：

PEDIATRIC NEPHROLOGY | 1995年 / 9卷 / 03期

关键词：

MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS; TREATMENT; CORTICOSTEROIDS; NEPHROTIC SYNDROME;

D O I：

10.1007/BF02254181

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Sixteen children with biopsy-confirmed type I membranoproliferative glomerulonephritis (MPGN) were treated with six alternate-day intravenous pulses of methylprednisolone followed by single-dose alternate-day prednisone for 12-66 months (mean 37 months). The average length of follow-up was 52 months (range 12-127 months). Compared with pretreatment values, the frequency of hematuria (13/16 vs. 8/16, P<0.05) and the levels of serum albumin (2.66 +/- 0.69 vs. 3.76 +/- 0.39 g/dl, P<0.001), creatinine clearance (97 +/- 37 vs. 129 +/- 26 ml/min/1.73 m(2), P<0.001), and proteinuria (5.2 +/- 5.1 vs. 1.0 +/- 0.8 g/day, P<0.001) were significantly improved after 3 months of therapy. Improvement has persisted through the end of the follow-up period. Repeat kidney biopsies showed a significant reduction in acute changes but an increase in chronic changes. Thirteen patients have been off therapy from 1 to 74 months (mean 20.8 months). Nine have a normal urinalysis, creatinine clearance, and protein excretion. The remainder have normal renal function but proteinuria ranging from 3.2 to 4.3 g/day. The data support the evidence of other investigators that corticosteroid therapy is beneficial in type I MPGN and suggest that initiation with pulse methylprednisolone may promote early stabilization of the disease.

引用

页码：268 / 271

页数：4

共 18 条

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