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May 1979

High-Dose CorticosteroidsTheir Use in Treating Idiopathic Rapidly Progressive Glomerulonephritis

Author Affiliations

From the Division of Kidney Disease, Department of Medicine, University of Utah College of Medicine, and the Veterans Administration Hospital, Salt Lake City. Dr O'Neill is now with the Section of Nephrology, Tulane University School of Medicine, New Orleans.

Arch Intern Med. 1979;139(5):514-518. doi:10.1001/archinte.1979.03630420010007

To evaluate the response of patients with idiopathic rapidly progressive glomerulonephritis (RPGN) to high-dose corticosteroids, we have studied ten consecutive patients with this disorder. All were given 1 g of methylprednisolone intravenously each day for one week and then placed on a high-dose orally administered prednisone regimen. Four of the ten patients with idiopathic RPGN responded with a sustained reduction in the serum creatinine level of at least 50%. The patients who responded were characterized by a symptomatic illness of short duration and normal blood pressure. Renal biopsies in the responding patients showed minimal glomerular and crescentic sclerosis with mild interstitial fibrosis. The nonresponders had a long symptomatic illness with elevated initial blood pressures. The renal tissue in this group had considerable fibrosis of the crescents, glomeruli, and interstitium. The results suggest that a certain group of patients with idiopathic RPGN will improve with high-dose corticosteroid therapy.

(Arch Intern Med 139:514-518, 1979)