Long-term effects of steroid and cytostatic treatment on the clinical course of idiopathic membranous glomerulonephritis (retrospective study).

The clinical course of 30 patients with idiopathic membranous glomerulonephritis has been followed up for 8.1 +/- 3.4 (4-17) years. First, in each case a long-term prednisone treatment was administered. During this therapy 12 (40%) patients improved and 9 had remission. In the 18 (60%) steroid resistant cases the treatment was combined with cytostatic drugs. After a combined regime for 1.9 +/- 0.8 years, 8 patients have improved, 2 of whom remitted. It has been suggested that due to a long-term immunomodulator therapy the level of urinary protein excretion might be reduced in 77% of patients. There was no effect of the applied treatment in 7% of cases, still in 16% a gradual deterioration was observed. Relapsing nephrotic syndrome has occurred in 3 (10%) of the total cases. Side effects requiring cessation of treatment were not observed.