Membranous nephropathy with chronic renal failure. Partial native renal function recovery after unsuccessful renal transplant.

• A patient with chronic renal failure due to idiopathic membranous nephropathy responded with improvement of his native renal function after treatment with prednisone and azathioprine for an unsuccessful renal transplant. Chronic renal failure developed gradually more than five years after the onset of nephrotic syndrome, despite early separate trials of prednisone and azathioprine. When uremic symptoms occurred, he received a transplant from a living related donor. Early function was good, but he subsequently had two acute rejection episodes with a rise in creatinine level. Renal scans demonstrated no function of the transplanted kidney, and surgical exploration showed a totally necrotic transplant kidney. Since initial transplant, he has been receiving maintenance immunosuppression therapy with prednisone and azathioprine. His creatinine level decreased to 3.0 to 4.3 mg/dL, and an intravenous pyelogram has shown definite though decreased function of his native kidneys. ( Arch Intern Med 140:437-438, 1980)