[Glucocorticoid therapy in renal diseases--its indication and therapeutic schedule]

Glucocorticoid therapy is used to treat renal diseases because of the two pharmacological actions, i.e anti-inflammatory and Immunosuppressive ones. Indications for steroid therapy in renal diseases are mainly primary and secondary nephritis and the nephrotic syndrome. These include minimal change nephrotic syndrome, membranous nephropathy, membranoproliferative glomerulonephritis, focal glomerular sclerosis, rapidly progressive glomerulonephritis, IgA nephropathy (in part), lupus nephritis, acute interstitial nephritis and so on. There are two routes of steroid administration, orally or intravenously, to treat nephritis and the nephrotic syndrome. The standard therapeutic regimen is the oral administration of prednisolone (PSL), which usually consists of initial high dose therapy (40-60 mg/day), subsequent withdrawal of steroids and maintenance therapy. As for intravenous administration, high dose injection of methylprednisolone (usually 1000 mg on three successive days) is utilized and followed by high dose oral PSL.