ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO1109

The Short and Long Term Effect of Methylprednisolone Pulse Therapy for Lupus Nephritis Treated with Multi-target Therapy

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Lan, Lan, Zhejiang University, Hangzhou, ZheJiang, China
  • Lang, Xiabing, Zhejiang University, Hangzhou, ZheJiang, China
Background

Muti-target therapy was applied to the severe lupus nephritis, especially the patients with severe proteinuria. Methylprednisolon pulse therapy was used in the initial phase of induction therapy in some patients. We conducted this study to assess the short and long term effect of methylprednisolon pulse therapy on the lupus nephritis patients treated with muti-target therapy.

Methods

It's a retrospective study from 2007-2016, 43 patients diagnosed as lupus nephritis received muti-target therapy in our center, including prednisone combined with MMF and tacrolimus. 19 patients received methylprednisolon pulse therapy in the initial phase of induction therapy, 24 patients only received prednisone combined with MMF and tacrolimus. The dose of methylprednisolon pulse therapy was intravenous injection 500mg*3 days, following prednisone dose was 0.8-1.0mg/kg. The dose of MMF was 1.0-1.5g/d, the initial dose of tacrolimus was 0.05 mg/kg/d, the target trough levels was 3 to 8 ng/mL for 24 weeks, and then reduced to 3 to 6 ng/mL. In the patients combined with acute renal injury (AKI), we accessed the short term outcome by the decrease of serum creatinine in 1 and 3 month. Long term outcome variables included mean remission rate, average remission time.

Results

There was a significant difference in the decrease of creatinine between the two groups in 1 month (P=0.04). However, there was no significant difference in 3 month. In the 12 months follow up, 16 of 19 patients in the methylprednisolon pulse therapy group (84.2%) experienced remission (either complete or partial), and 12 of 19 patients (63.1%) experienced complete remission. In the group only receive muti-target therapy, 20 of 24 (83.3%) patients experienced remission, and 13 of 24 patients (54.2%) experienced complete remission. There were no significant difference in remission rate and remission time between the two groups (p=0.93 p=0.87). We also did not found significant difference in the serum creatinine and UP/Cr in 3, 6, 12month.

Conclusion

Methylprednisolon pulse therapy seemed had no significant effect on the long-term prognosis of lupus nephritis treated with muti-target therapy, but maybe it had better effect on the recovery of AKI patients.