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November 1966

Cytotoxic Drugs in Steroid-Resistant Renal Disease: Alkylating and Antimetabolic Agents in the Treatment of Nephrotic Syndrome, Lupus Nephritis, Chronic Glomerulonephritis, and Purpura Nephritis in Children

Author Affiliations

From the Department of Pediatrics, Western Reserve University School of Medicine, Cleveland.

Am J Dis Child. 1966;112(5):448-458. doi:10.1001/archpedi.1966.02090140120011

THE USE of cytotoxic agents in the treatment of renal diseases was first reported in 1949 by Chasis1,2 using nitrogen mustard (mechlorethamine) in adults with chronic glomerulonephritis. Shortly thereafter, Kelley and Panos3 confirmed improvement in children with nephrosis, and Taylor4 in adults with chronic glomerulonephritis, using the same approach. These reports were followed by others,5-9 but as the therapeutic value of steroids became more widely accepted, cytotoxic drugs were displaced as therapeutic agents. Interest was renewed in 1963 by Coldbeck,10 Kellum and Haserick,11 and Goodman and Wolff.12 There has been further encouragement in the use of these agents in the treatment of other nonneoplastic diseases12-15 as well as in renal diseases.15-22

This report will review 3½ years' experience in 25 children with cytotoxic drugs in addition to corticosteroids in the treatment of chronic renal diseases.

Patients and Methods  The agents used