[Long-term renal prognosis in patients with lupus nephritis treated with pulse methylprednisolone]

To elucidate the long-term renal prognosis in patients with lupus nephritis treated with pulse methylprednisolone, the renal outcome and the risk factors associated with poor renal prognosis were studied in 14 female lupus nephritis patients treated with pulse methylprednisolone. The mean age when the pulse methylprednisolone was started was 28.1 years old and their renal pathology were 3 of WHO III, 10 of WHO IV and 1 of WHO V. Four of the patients fell into renal insufficiency at 5.7 (mean, 1.3 approximately 10) years after pulse methylprednisolone, however residual 10 patients kept their renal function for 11.5 (mean, 3.5 approximately 19.6) years observation. The deterioration of renal function significantly (p = 0.033) correlated with glomerular sclerosing index before pulse methylprednisolone, but did not correlate with sustained immunological activity, hypoproteinemia or hypertension. Because glomerular sclerosing index was thought to be one of the risk factors for poor renal prognosis, the indication for pulse methylprednisolone in lupus nephritis was the patients with low glomerular sclerosing index.