Document Detail

Treatment of membranous lupus nephritis.
MedLine Citation:
PMID:  9531186     Owner:  NLM     Status:  MEDLINE    
In this study, we retrospectively analyzed the effects of treatment in 19 patients with membranous lupus nephritis (MLN) and nephrotic syndrome. Eight patients were treated with corticosteroids alone, and the other 11 patients received methylprednisolone and chlorambucil alternated every other month for 6 months. At presentation, sex, age, duration of renal disease before renal biopsy, plasma creatinine, and arterial hypertension were similar in the two study groups. Of the eight patients treated with corticosteroids alone, three showed complete remission and one partial remission of the nephrotic syndrome. During the follow-up (mean, 114+/-63 months), seven of these eight patients developed one or more renal flare-ups. Of the 11 patients treated with methylprednisolone and chlorambucil, seven had complete remission, and the other four had partial remission of the nephrotic syndrome. During the follow-up (mean, 83+/-59 months), only one patient had renal flare-up. At the end of the follow-up, all patients were alive, but three patients in the group treated with corticosteroids alone had developed a doubling of plasma creatinine, and another patient had persistent nephrotic syndrome. Two other patients were in complete remission, one patient was in partial remission, and the last patient had nonnephrotic proteinuria. In the group of patients treated with methylprednisolone and chlorambucil, one patient developed extracapillary glomerulonephritis and eventually entered end-stage renal failure 24 years after the clinical onset of renal disease. Seven patients were in complete remission, and three patients were in partial remission at the last follow-up visit. This retrospective study suggests that methylprednisolone and chlorambucil may induce a more stable remission of nephrotic syndrome and may better protect renal function in the long term in comparison with corticosteroids alone. However, these results must be confirmed by a prospective controlled trial.
G Moroni; M Maccario; G Banfi; S Quaglini; C Ponticelli
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  31     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  1998 Apr 
Date Detail:
Created Date:  1998-04-16     Completed Date:  1998-04-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  681-6     Citation Subset:  IM    
Division of Nephrology and Dialysis, IRCCS, Ospedale Maggiore, Milano, Italy.
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MeSH Terms
Adrenal Cortex Hormones / administration & dosage
Chlorambucil / administration & dosage
Drug Evaluation
Drug Therapy, Combination
Glucocorticoids / administration & dosage
Lupus Nephritis / drug therapy*
Methylprednisolone / administration & dosage
Middle Aged
Nephrotic Syndrome / drug therapy
Proteinuria / drug therapy
Retrospective Studies
Time Factors
Treatment Outcome
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Glucocorticoids; 305-03-3/Chlorambucil; 83-43-2/Methylprednisolone

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