[Fulminant course of glomerulonephritis with acute renal failure in a 63-year old man]

A 63-year old man presented with severe nephrotic syndrome and acute renal failure, accompanied by congestive circulatory insufficiency and hypertension. During the next four days, despite intense symptomatic treatment of nephrotic syndrome impairment of glomerular filtration continued to progress (serum creatinine rose from 6.5 mg/dl to 7.5 mg/dl) and 24-hour proteinuria reached 26.7 g, while proteinaemia was 43.7 g/l. After having excluded malignancy and systemic disease, patient was given two doses of methylprednisolone (750 mg every other day) along with haemodialyses on three consecutive days. On the fourth day dialyses were stopped due to development of poliuria. Patient's circulation parameters have improved and so did the renal function. Kidney biopsy revealed scarce glomerular proliferation and interstitial mononu: clear infiltrates. Steroids being continued (prednisone 50 mg on alternate days), patient's condition continued to improve, results of laboratory tests practically returned to normal and two subsequent hospital observations within monthly intervals confirmed stability of remission.