We reviewed 123 cases of adult patients with idiopathic nephrotic syndrome in Kyung Hee University Hospital from March 1986 to Febrary 1991 and evaluated the therapeutic response of prednisolone therapy and combined therapy with prednisolone and
cyclophosphamide in 96 patients who were followed up to more than 2 months, retrospectively.
@ES The results were as follows;
@EN 1) Histopathologic findings in 123 adult patients with idiopathic nephrotic syndrome were mininal change disease (MCD, 37.4%), membranous glomerulonephritis (MGN, 24.4%), IgA nephropathy (IA N, 15.4%), membranoproliferative glomerulonephritis
(MPGN,
12.2%), focal segmental glomerulosclerosis (FSGS, 7.3%) and mesangial proliferative glomerulonephritis (MsPGN, 3.3%).
2) In steroid therapy group (n=56), MCD showed the complete remission in 83.3%, partial remission in 3.3% and IgA N showed the complete remission in 70.0%, partial remission in 10.0%. However, others showed only partial remission or no response.
3) In steroid resistant or dependent patients (n=18), the complete andpartial remission rate were 77.8% and 22.2% in MCD, 66.7% and 33.3% in IgA N, and 50.0% and 33.3% in MGN with the addition of cyclophosphamide.
4) In combined therapy group (n=40), the complete and partial remission rate were 100.0% and 0% in MCD, 60.0% and 20.0% in IgA N and FSGS, 23.1% and 46.2% in MGN, 0% and 55.6% in MPGN.
5) The relapse rate in steroid and combined therapy group were 60.0% ad 50.0% in CD, 100.0% and 33.3% in MGN and 85.8% and 66.7% in IgA N.
6) During the immunosuppressive therapy, two patients developed pneumonia which was treated successfully with antibiotics and one patients developed alopecia.
In conclusion, sterid therapy is effective as an initial treatment in the patients with MCD and IgA N and the combined therapy of steroid and cyclophosphamide is more effective than steroid alone in the patients with MGN. The addition of
cyclophosphamide is effective in sterid resistant state of MCD, MGN and IgA nephropathy.
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