Schmidt P, Pinggera W F, Zazgornik J, Stummvoll H K, Wolf A, Kopsa H, Pils P
Int Urol Nephrol. 1979;11(1):61-6. doi: 10.1007/BF02082813.
The clinical observation of 6 out of 250 renal transplant patients showed that acute renal rejection may lead to reversible acute tubular necrosis (ATN) necessitating intermittent haemodialysis treatment. Despite missing early response to high-dose (methyl-) prednisolone therapy (during a mean period of 4.7 days) all 6 patients developed spontaneous diuresis 14.5 days on average after onset of rejection while on maintenance immunosuppressive therapy. From the clinical course the conclusion was drawn that in severe cases of renal rejection with arteriographic and histological findings consistent with acute tubular necrosis, prolonged therapy with high doses of (methyl-) prednisolone is not desirable, since after reversal of immunological rejection the onset of spontaneous diuresis will be determined mainly by the duration of the healing and recovery phase of acute tubular necrosis.
对250例肾移植患者中的6例进行的临床观察表明，急性肾排斥反应可能导致可逆性急性肾小管坏死（ATN），需要进行间歇性血液透析治疗。尽管对高剂量（甲基）泼尼松龙治疗缺乏早期反应（平均持续4.7天），但所有6例患者在排斥反应发作后平均14.5天在维持免疫抑制治疗期间出现了自发性利尿。从临床过程得出的结论是，在肾排斥反应严重且血管造影和组织学结果与急性肾小管坏死一致的情况下，不建议长时间使用高剂量（甲基）泼尼松龙治疗，因为在免疫排斥反应逆转后，自发性利尿的开始将主要取决于急性肾小管坏死愈合和恢复阶段的持续时间。
