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Membranoproliferative glomerulonephritis: the Cincinnati experience--cumulative renal survival from 1957 to 1989
1Children's Hospital Research Foundation, Cincinnati, OH 45229-2899.
Insights
This study followed 76 children with idiopathic MPGN, finding that long-term prednisone treatment improved renal survival rates. Renal survival was 82% at 10 years and 56% at 20 years in treated patients.
Area of Science:
- Pediatric Nephrology
- Immunosuppressive Therapy
- Glomerulonephritis
Background:
- Idiopathic Membranoproliferative Glomerulonephritis (MPGN) is a serious kidney disease in children.
- Long-term outcomes and treatment efficacy for pediatric MPGN require further investigation.
Purpose of the Study:
- To evaluate the long-term efficacy of prednisone monotherapy in children with idiopathic MPGN.
- To assess cumulative renal survival rates in pediatric patients treated with prednisone.
Main Methods:
- Retrospective follow-up of 76 children diagnosed with idiopathic MPGN since 1957.
- Analysis of renal survival in 71 children treated with alternate-day prednisone, with other immunosuppressants avoided since 1981.
Main Results:
- Cumulative renal survival was 82% at 10 years and 56% at 20 years post-disease onset in treated patients.
- Renal survival calculated from prednisone initiation showed 75% at 10 years and 59% at 20 years.
- Improved long-term renal survival correlated with increased institutional experience.
Conclusions:
- Alternate-day prednisone monotherapy demonstrates significant long-term renal survival benefits for pediatric idiopathic MPGN.
- The findings suggest that consistent therapeutic approaches can improve outcomes in this challenging condition.
- Continued research and experience enhance the management and prognosis of childhood MPGN.
Abstract:
Seventy-six children with idiopathic MPGN have been followed at this medical center since 1957 (mean 10.6 years of disease). Seventy-one of the children have been treated with a regimen of prednisone (mean 7.7 years of treatment). Monotherapy with alternate-day prednisone was used in 50 of the children. Other immunosuppressive and cytotoxic drugs have not been used since 1981. In the 71 treated patients, the cumulative renal survival (creatinine less than 3.0 mg/dl (265.5 mumol/L)) was 82% in the tenth year and 56% in the twentieth year after disease onset. Cumulative renal survival, calculated from the date of initiation of the prednisone regimen, was 75% in the tenth year and 59% in the twentieth year. As our experience with this disease has increased, long-term cumulative renal survival has improved.