[Acute post-streptococcal glomerulonephritis in adults--corticosteroid therapy, yes or no?]

The aim of this study was to investigate the influence of the corticosteroid therapy on the development and prognosis of proststreptococcal glomerulonephritis (PSGN) in the period of five years. The investigation included a group of 54 patients who were in the acute phase of poststreptococcal glomerulonephritis (PSGN) when they were 18-22 years old. Corticosteroids were administered per os with the starting dose of 0.5 mg/kg bm, and the dose was subsequently decreased by 5 mg every 10 days to 20 mg/per day within 8 weeks of therapy. We have treated ten patients and all were with severe clinical manifestations of the disease (acute renal failure, oliguria, edemas, hypertension) and severe histopathologic (HP) finding of kidney tissue on the initial biopsy. On the basis of clinical parameters, HP changes on the repeated biopsy of the kidney and five years follow-up, we have concluded that the remission of the disease was achieved in patients who had received corticosteroid therapy. Clinical findings were confirmed by PH findings of repeated biopsies with less expressed residues of the disease. Corticosteroid therapy should be administered in adult patients who are in the acute phase of the disease, with clinical and HP severe form of PSGN, since the risk for the further progress of more serious sequelae of the disease is significantly decreased.