Abstract
Twenty-nine patients with biopsy proven severe proliferative glomerulonephritis were treated with 6 alternate day “pulses” of 30 mg/kg each. Pre- and post-treatment inulin clearances (ml/min/1.73m2) and maximum GFR achieved after pulses were (mean±SEM):
CPAH increased with pulse therapy in all groups, increasing from 307 ± 62.2 to 644 ± 81.3 ml/min/1.73m2 in HSP patients (p<.02). Protein excretion decreased from pre-treatment 3.7 ± 1.0 to 1.4 ± 0.4 g/day post-treatment. Side effects of pulse therapy were few, hypertension being seen only in patients with pre-existing hypertension. Improvements in GFR following pulses were maintained in 25 patients treated subsequently with oral Prednisone-initial dose 2 mg/kg with subsequent stepwise reductions. Of the four patients failing to maintain improvement after pulses, three were treated late in the course of their disease.
These observations support our preliminary findings (J.Peds, 88,307,1976) that the use of steroids in pulse doses relatively early in the course of patients with severe glomerulonephritis is beneficial and improves their prognosis.
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Rose, G., Morris, K., Cole, B. et al. HIGH DOSE INTRAVENOUS METHYLPREDNISOLONE BOLUS THERAPY (“PULSES”) IN SEVERE PROLIFERATIVE GLOMERULO-NEPHRITIS. Pediatr Res 14, 1006 (1980). https://doi.org/10.1203/00006450-198008000-00199
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DOI: https://doi.org/10.1203/00006450-198008000-00199
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