High-dose corticosteroids: their use in treating idiopathic rapidly progressive glomerulonephritis

Abstract

To evaluate the response of patients with idiopathic rapidly progressive glomerulonephritis (RPGN) to high-dose corticosteroids, 10 consecutive patients with this disorder were studied. All were given 1 g of methylprednisolone i.v. each day for 1 wk and then placed on a high-dose orally administered prednisone regimen. Four of the 10 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 intial blood pressures. The renal tissue in this group had considerable fibrosis of the crescents, glomeruli and interstitium. A certain group of patients with idiopathic RPGN may improve with high-dose corticosteroid therapy.