J Korean Soc Pediatr Nephrol.  2007 Oct;11(2):178-184.

The Prognosis of Focal Segmental Glomerulosclerosis Patients with Methylprednisolone Pulse Therapy Alone

• Kim JA
• Park KS
• Shin JI
• Jeong IC
• Kim JH
• Lee JS
• Kim PK
• Jeong HJ

Abstract

PURPOSE: Since the first report by Mendoza in 1990, there have been several studies reporting that long-term intravenous methylprednisolone(MP) pulse therapy combined with cyclosporin A(CsA) or cyclophosphamide might be beneficial for the treatment of steroid resistant focal segmental glomerulosclerosis(FSGS). We investigated the therapeutic effect of long-term MP pulse therapy without CsA or cyclophosphamide on steroid resistant FSGS.
METHODS
The medical records of the 10 steroid resistant FSGS patients who were treated with MP pulse therapy by the Mendoza protocol without CsA or cyclophosphamide in our hospital were retrospectively reviewed.
RESULTS
The median age at onset was 2.6 years(range 1.1-10.6 years) and the median age at the initiation of therapy was 5.7 years(range 1.8-20 years). The median duration of follow-up was 35 months(range 4-132 months). At the end of therapy, 5 patients achieved complete remission(50%) and 2 partial remission(20%), one of whom relapsed after the therapy. Three patients did not respond to the therapy, two of whom progressed to end-stage renal failure during the therapy eventually requiring kidney transplantation.
CONCLUSION
Intravenous long-term MP pulse therapy without CsA or cyclophosphamide by the Mendoza protocol may be effective in a subset of patients with steroid-resistant FSGS.

Keyword

Mendoza protocol; Methylprednisolone pulse therapy; Focal segmental glomerulosclerosis

MeSH Terms

Cyclophosphamide
Cyclosporine
Follow-Up Studies
Glomerulosclerosis, Focal Segmental*
Humans
Kidney Failure, Chronic
Kidney Transplantation
Medical Records
Methylprednisolone*
Prognosis*
Retrospective Studies
Cyclophosphamide
Cyclosporine
Methylprednisolone