INTRAVENOUS PULSE CYCLOPHOSPHAMIDE TREATMENT OF LUPUS NEPHRITIS: A RETROSPECTIVE TEN YEARS STUDY

Abstract

Nephritis remains an important problem in patients with systemic lupus erythematosus (SLE). We conducted retrospective study to evaluate the efficiency of intravenous pulse cyclophosphamide in lupus nephritis: From 1983 to 1993, we reviewed 133 patients with biopsy proven lupus nephritis, 47 of them excluded because of short period of follow-up or defective laboratory data. Eighty six patients were treated with the following regimens: Sixty patients with intravenous pulse cyclophospham; 13 witli IV pulse methylprednisolone succinate, 8 with cyclosporine, 4 with azathioprine and one with oral prednisolone. Sixteen patients did not respond to IV cyclophosphamide. We evaluated renal biopsy, pretreatment mean arterial pressure (MAP), BUN, creatinine and proteinuria as-prognostic and risk factors of nonresponders. The results of this study showed that diffuse proliferative glomerulonephritis (DPGN) had the poorest outcome and most of nonresponders (11/16), were of DPGN. Tliere was a correlation between initial serum creatinine level and response to IV cyclophosphamide, but there was no correlation between BUN, MAP, degree of proteinuria and response to IV cyclophosphamide. IV pulse cyclophosphamid was more effective than steroid alone in preventing renal failure in lupus nephritis.