[Therapeutic effect of defibrase in chronic glomerulonephritis with chronic renal failure]

When chronic glomerulonephritis (CGN) proceeds to chronic renal failure (CRF), there are decline of fibrinolytic activity and deposition of fibrin in glomeruli with resulting thromboembolic lesions. 46 CGN patients with complicating CRF were thus treated with defibrase made from viper venom. Defibrase in a dose of 0.025 unit/kg dissolved in 250 ml 10% glucose was infused slowly once every 3 days in a total of 6 times. After the treatment, BUN and serum creatinine levels decreased, creatinine cleance improved and the clinical manifestations of uremia alleviated or disappeared. In some patients there were increase of hemoglobin concentration and decrease of urinary protein excretion. Hypertension was controlled in 17 out of 20 patients treated in combination with captopril. Level of plasma fibrinogen was significantly reduced after defibrase administration, but the reduction was not related to the therapeutic effect. Urinary output was increased in most of the patients, being related to the therapeutic effect. The authors are of the opinion that renal function may be improved in CGN patients after defibrase treatment due probably to elimination of fibrin deposition and resolution of thromboembolic lesions in glomeruli. However, a suitable dose has to be determined as there is no effective way to monitor the most dreaded complication of defibrase therapy bleeding.