OUTCOME of PULSE CYCLOPHOSPHAMIDE (PCP) in TYPE IV SLE NEPHRITIS WITHOUT RENAL FAILURE.


Abstract: Results of PCP are well known in lupus nephritis. We present here it's outcome in patients with early stage of WH0 type IV lupus nephritis. The criteria for selection was a serum creatinine inferior to 1.3 mg/ 100 ml and a minimum follow up time of 18 months. 35 patients fulfilled the selection criteria. proteinuria, hematuria, leucocyturia, cast, BUN, creatinine, and blood pressure were measured before PCP and after each one. The first and the last measurements were compared to each other by the Student paired t test. Cyclophos­phamide was given as 1000 mg per m2 of body sur­face. Prednisolone was administered, per os, as 1/2 mg/kg/daily. PCP was repeated once per month. Upon the achievement of a satisfactory improvement PCP was delayed to 2 and then to 3 months, and pred­nisolone was tapered gradually. RESULTS: The mean follow up time was 32 months. The mean PCP per patient was 10. The 24 h. proteinuria improved in all but 1 patient (mean before 2453, mean after 490 mg, t=5.519, p<0.01). Hematuria im­proved in all but 1 patient (mean before 22.1, mean after 4.5 RBC/microscopic field, t=6.472, p<0.001). Casts improved in all but 1 patient (mean before 3.4, mean after 0.1/microscopic field, t=3.366, p<0.01). only in 1 patient the serum creatinine raised from 0.9 to 1.3.