Intravenous methylprednisolone pulse therapy in minimal change nephrotic syndrome

The effectiveness of intravenous methylprednisolone pulses in 20 mg/kg/day for three consecutive days was compared with a more conventional oral prednisone regime in inducing remission in adult patients presenting with first episodes of minimal change nephrotic syndrome. Methylprednisolone was significantly less effective and failed to induce remission in six of nine patients within two weeks of treatment, while the oral prednisone regime was uniformly effective in all eight patients within five weeks. Of the six non-responders to methylprednisolone five subsequently remitted with oral prednisone, and one with cyclophosphamide. Except for one patient in the oral prednisone group who had acute gastritis with bleeding, no serious side-effect was seen with either treatment regimes.