The advantages of immunosuppressive therapy in renal disease.

The beneficial effects of steroids and/or immunosuppressive drugs in idiopathic nephrotic syndrome are rarely disputed. On the other hand, there are contrasting ideas on the usefulness of this therapy in some forms of glomerulonephritis (GN) such as rapidly progressive GN and membranous GN with nephrotic syndrome. Many observations suggest that methylprednisolone pulse and/or plasma exchange associated with cyclophosphamide may significantly improve the natural course of rapidly progressive GN. Moreover, our treatment schedule consisting of methylprednisolone and chlorambucil alternatively given for 6 months significantly increases the chances of a complete remission of the disease in patients with membranous GN and nephrotic syndrome.