Abstract
In 1980, we reported that in 27 children with MPGN, treatment with high dose qod prednisone preserved renal function and improved glomerular morphology. To date, 48 children have been treated for periods of 2 to 20 years (mean 8 years) with prednisone in a dose of 2 mg/kg qod to a maximum dose of 80 mg qod until a renal biopsy 2 years after the start of treatment. Thereafter, the dose has been slowly reduced to a maintenance of 20 mg qod. Of the 43 patients with improvement, the interval between disease discovery and initiation of therapy was 1.5 years while in those 5 who developed ESRD the interval averaged 5 years. Survival was not related to MPGN type. Serial renal biopsies have shown improvement in glomerular morphology. Persistent hypertension responded well to antihypertensive medication. Most of the children had some decrease in height increment with the prednisone regimen. Life table analysis indicates a 97% survival 10 years after diagnosis and 88% survival after 11 years. Habib, et.al. and Cameron, et.al. have both reported survival of 50% at 10 years in a series of, respectively, 105 and 45 children. The less impressive outcome of patients in the controlled trial of alternate day prednisone as reported by the International Study of Kidney Disease in Children is unclear.
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McEnery, P., West, C. & McAdams, A. ALTERNATE DAY (QOD) PREDNISONE IN MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS (MPGN): RESULTS ON 48 CHILDREN, 1957 THROUGH 1983. Pediatr Res 18 (Suppl 4), 365 (1984). https://doi.org/10.1203/00006450-198404001-01633
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DOI: https://doi.org/10.1203/00006450-198404001-01633