Pulse methylprednisolone therapy in idiopathic, rapidly progressive glomerulonephritis.

Idiopathic crescentic glomerulonephritis is associated with a 70% to 80% incidence of end-stage renal failure. Oral corticosteroid therapy in combination with immunosuppressive agents or anticoagulants has not altered the prognosis of this disease. We have seen five adults with idiopathic crescentic glomerulonephritis and treated them with intravenous methylprednisolone. Before therapy, the average serum creatinine concentration was 7.4 +/- 1.3 mg/dL (chi-square +/- SEM). This value declined to 2.0 +/- 0.48 mg/dL within 4 weeks. All patients continue to maintain stable renal function over an average follow-up period of 19 months (range 1.5 to 36 months). These data suggest that a prospective controlled trial of this therapy is warranted in the management of this entity.

[1]  W. Etheridge,et al.  High-dose corticosteroids: their use in treating idiopathic rapidly progressive glomerulonephritis. , 1979, Archives of internal medicine.

[2]  W. Couser,et al.  Intravenous pulse methylprednisolone therapy of acute crescentic rapidly progressive glomerulonephritis. , 1979, The American journal of medicine.

[3]  A. Saxon,et al.  Glucocorticoids administered in vivo inhibit human suppressor T lymphocyte function and diminish B lymphocyte responsiveness in in vitro immunoglobulin synthesis. , 1978, The Journal of clinical investigation.

[4]  S. Zimmerman,et al.  IDIOPATHIC CRESCENTIC GLOMERULONEPHRITIS , 1977, Medicine.

[5]  N. Ordóñez,et al.  The differential diagnosis of crescentic glomerulonephritis. The pathology of specific lesions with prognostic implications. , 1977, Human pathology.

[6]  J. Brocklebank,et al.  "Pulse" methylprednisolone therapy in the treatment of severe glomerulonephritis. , 1976, The Journal of pediatrics.

[7]  W. Couser,et al.  BENEFICIAL EFFECTS OF METHYLPREDNISOLONE "PULSE" THERAPY IN DIFFUSE PROLIFERATIVE LUPUS NEPHRITIS , 1976, The Lancet.

[8]  R. Schrier,et al.  Serious pulmonary hemorrhage, glomerulonephritis, and massive steroid therapy. , 1975, Annals of internal medicine.

[9]  C. Chantler,et al.  COMBINED IMMUNOSUPPRESSION AND ANTICOAGULATION IN RAPIDLY PROGRESSIVE GLOMERULONEPHRITIS , 1974, The Lancet.

[10]  W. J. Johnson,et al.  High-dosage intravenously administered methylprednisolone in renal transplantation. A preliminary report. , 1973, JAMA.

[11]  J. Maher,et al.  Natural history of oliguric glomerulonephritis. , 1973, Perspectives in nephrology and hypertension.

[12]  J. E. Woods,et al.  Effects of a large dose of methylprednisolone on renal function. , 1972, The Journal of laboratory and clinical medicine.

[13]  V. Pollak,et al.  Rapidly progressive (nonstreptococcal) glomerulonephritis. , 1968, Annals of internal medicine.