[Combined therapy of membranoproliferative glomerulonephritis in older patients]

The aim of the study was to investigate the effectiveness of combined long-term therapy by cytostatics and steroid hormones in older patients with membranoproliferative glomerulonephritis to halt renal failure progression. 27 patients older than 60 years with morphologically proved membranoproliferative glomerulonephritis have been treated. Nephrosclerosis was detected in 40% of studied patients according to results of kidney biopsies. The mean age of the patients was 65.8 +/- 1.5 years. The activity of the disease depended on presence and severity of nephrotic syndrome. 17 (62.9%) patients had coronary heart disease, 7 (25.9%) patients had chronic bronchitis, 7 (25.9%) patients had peptic ulcer disease in a remission phase. Patients received therapy by cyclophosphamide in a dose of 2 mg/kg daily and prednisolone in a dose of 1 mg/kg daily during 2 years. Tolerability of assigned treatment was satisfactory. The main clinical and laboratory signs of nephrotic syndrome were significantly reduced and the proof remission was reached after 8-12 months of combined therapy. During the observation (24 month) the glomerular filtration rate in studied patients didn't decreased over 30-59 mL/min/1.73 m2 and corresponded to stage 3 of chronic kidney disease.