Abstract
Thirteen patients with lupus renal insufficiency derived from systemic lupus erythematosus were treated with two different types of therapy. Six out of 13 patients were treated by high dosis intravenous administration of methylprednisolone "pulse" therapy and 7 patients were treated by oral administration of daily 40 to 60 mg of prednisolone. All patints were serologically active. Serumm creatinine and complement level (CH 50) were measured weekly. Serial renal biopsy was performed before and 6 months after two types of therapy. Beneficial effects were evaluated 6 monts after therapy. Three of 6 patients treated by pulse therapy had become to be free from renal insufficiency within 3 months. No significant improvements of renal function were obtained in the other 3 patients. None of patients in this group showed deterioration to severe renal failure. Two of 7 patients treated by oral prednisolone were free from renal insufficiency 6 months after therapy, however, the other showed severe renal failure. Serum creatinine levels in these patients were from 5.2 to 7.5 mg/dl. A rapid improvement of CH50 was obtained in patients with pulse therapy. A dramatic improvement of renal function documented by Cathcart et al by 3 days consecutive pulse therapy was not obtained in the study. No serious side effects were observed in the patients with pulse therapy, while transitional accentuation of azotemia and decrease of urinary output were observed in all. Our results suggests that this type of therapy " pulse" is one of the treatment which one should try patients with renal insufficiency derived from SLE.
