Warady B A, Guggenheim S J, Sedman A, Lum G M
J Pediatr. 1985 Nov;107(5):702-7. doi: 10.1016/s0022-3476(85)80396-6.
Six children with biopsy-proved type 1 membranoproliferative glomerulonephritis (MPGN) improved clinically during a 2-year course of prednisone therapy. All children had nephrotic syndrome. Creatinine clearance was less than or equal to 80 ml/min/1.73 m2 in four patients. Initial prednisone dosage ranged from 20 mg every other day to 2 mg/kg/day (maximum 60 mg), with subsequent modifications based on improvement. After completion of a 2-year course of steroid therapy, a repeat kidney biopsy was performed in each child; a decrease in glomerular disease activity was noted in five of them. After a mean follow-up of almost 5 years, all children have creatinine clearance greater than 120 ml/min/1.73 m2, and only one remains nephrotic. Although the use of prednisone in children with MPGN remains controversial, we have observed a diminution in proteinuria and normalization of creatinine clearance with therapy initiated early in the disease course.
6名经活检证实为1型膜增生性肾小球肾炎（MPGN）的儿童在接受为期2年的泼尼松治疗过程中临床症状有所改善。所有儿童均患有肾病综合征。4例患者的肌酐清除率小于或等于80 ml/min/1.73 m²。初始泼尼松剂量为隔日20 mg至每日2 mg/kg（最大60 mg），随后根据病情改善情况进行调整。在完成2年的类固醇治疗疗程后，对每个儿童进行了重复肾活检；其中5例肾小球疾病活动度降低。经过近5年的平均随访，所有儿童的肌酐清除率均大于120 ml/min/1.73 m²，只有1例仍患有肾病。尽管在MPGN儿童中使用泼尼松仍存在争议，但我们观察到在疾病病程早期开始治疗可减少蛋白尿并使肌酐清除率恢复正常。
