Pulse cyclophosphamide in Lupus Nephritis.


Abstract: Pulse cyclophosphamide (PCP) is a well established method for the treatment of lupus nephritis. PCP seems to produce better results, and lesser side effects, than oral cytotoxic drugs. We present here, our ex­perience with this method, in 51 patients. All patients had a WHO type IV histological lesion, on light microscopy. Proteinuria, hematuria, leuco­cyturia, casts, BUN, creatinine, and blood pressure were measured before starting PCP and after each one. The first and the last measurment were compared to each other by the Student paired t test. Cyciophos­phamide. was given as 1000 mg per m2 of body surface, once per month. When a satisfactory result was, ob­tained, the gap between pulses was increased to 2 or 3 months. Prednisolone was administered, per os, as 1/2 mg per Kilogram of body weight. RESULTS: The mean follow up time was 17 months. The mean pulse per patient was 9 pulses. Proteinuria was improved in 80% of patients with t=4.110 and p<0.001. Hematuria improved in 84% of patients with t=5.049 and p<0.001. Leucocyturia improved in 73% of patients with t=2.101 and p<0.05. Casts improved in 89% of patients with t=5.040 and p<0. 001. Creatinine improved in 73% of patients with t=2.872 and p<0.01. The changes in abnormal BUN and blood pressure were not statistically significant. Side effects were minor: Nausea and vomiting after PCP, and moderate hair loss in some patients.