Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Response of type I membranoproliferative glomerulonephritis to pulse methylprednisolone and alternate-day prednisone therapy

  • 66 Accesses

  • 26 Citations


Sixteen children with biopsy-confirmed type I membranoproliferative glomerulonephritis (MPGN) were treated with six alternate-day intravenous pulses of methylprednisolone followed by single-dose alternate-day prednisone for 12–66 months (mean 37 months). The average length of follow-up was 52 months (range 12–127 months). Compared with pretreatment values, the frequency of hematuria (13/16 vs. 8/16,P<0.05) and the levels of serum albumin (2.66 ± 0.69 vs. 3.76 ± 0.39 g/dl,P < 0.001), creatinine clearance (97 ± 37 vs. 129 ± 26 ml/ min/1.73 m2,P<0.001), and proteinuria (5.2 ± 5.1 vs. 1.0 ± 0.8 g/day, P<0.001) were significantly improved after 3 months of therapy. Improvement has persisted through the end of the follow-up period. Repeat kidney biopsies showed a significant reduction in acute changes but an increase in chronic changes. Thirteen patients have been off therapy from 1 to 74 months (mean 20.8 months). Nine have a normal urinalysis, creatinine clearance, and protein excretion. The remainder have normal renal function but proteinuria ranging from 3.2 to 4.3 g/day. The data support the evidence of other investigators that corticosteroid therapy is beneficial in type I MPGN and suggest that initiation with pulse methylprednisolone may promote early stabilization of the disease.

This is a preview of subscription content, log in to check access.


  1. 1.

    Nash MA, Edelmann CM Jr, Bernstein J, Barnett HL (1992) The nephrotic syndrome. In: Edelmann CM Jr (ed) Pediatric kidney disease, 2nd edn. Little Brown, Boston, pp 1247–1266

  2. 2.

    D'Amico G, Ferrario F (1992) Mesangiocapillary glomerulonephritis. J Am Soc Nephrol 2:S159-S166

  3. 3.

    Schmitt H, Bohle A, Reineke T, Mayer-Eichberger D, Vogl W (1990) Long-term prognosis of membranoproliferative glomerulonephritis type I. Nephron 55:242–250

  4. 4.

    Cameron JS, Turner DR, Heaton J, Williams DG, Ogg CS, Chantler C, Haycock GB, Hicks J (1983) Idiopathic mesangiocapillary glomerulonephritis. Comparison of types I and II in children and adults and long-term prognosis. Am J Med 74:175–191

  5. 5.

    McEnery PT (1990) Membranoproliferative glomerulonephritis: the Cincinnati experience — cumulative renal survival from 1957 to 1989. J Pediatr 116:S109-S114

  6. 6.

    Tarshish P, Bernstein J, Tobin JN, Edelmann CM Jr (1992) Treatment of mesangiocapillary glomerulonephritis with alternate-day prednisone — a report of The International Study of Kidney Disease in Children. Pediatr Nephrol 6:123–130

  7. 7.

    Ford DM, Briscoe DM, Shanley PF, Lum GM (1992) Childhood membrano-proliferative glomerulonephritis type I: limited steroid therapy. Kidney Int 41:1606–1612

  8. 8.

    Mota-Hernandez F, Gordillo-Paniagua G, Munoz-Arizpe R, Lopez-Arriaga JA, Barboza-Madueno L (1985) Prednisone versus placebo in membrano-proliferative glomerulonephritis: long-term clinicopathological correlations. Int J Pediatr Nephrol 6:25–28

  9. 9.

    Donadio JV, Anderson CF, Mitchell JC III, Holley KE, Ilstrup DM, Fuster V, Chesebro JH (1984) Membranoproliferative glomerulonephritis. A prospective clinical trial of platelet-inhibitor therapy. N Engl J Med 310:1421–1426

  10. 10.

    Kincaid-Smith P (1972) The treatment of chronic mesangiocapillary (membranoproliferative) glomerulonephritis with impaired renal function. Med J Aust 2:587–592

  11. 11.

    Cattran DC, Cardella CJ, Roscoe JM, Charron RC, Rance PC, Ritchie SM, Corey PN (1985) Results of a controlled drug trial in membrano-proliferative glomerulonephritis. Kidney Int 27: 436–441

  12. 12.

    Zimmerman SW, Moorthy AV, Dreher WH, Friedman A, Varanasi U (1983) Prospective trial of warfarin and dipyridamole in patients with membranoproliferative glomerulonephritis. Am J Med 75: 920–927

  13. 13.

    Faedda R, Satta A, Tanda F, Pirisi M, Bartoli E (1994) Immunosuppressive treatment of membranoproliferative glomerulonephritis. Nephron 67:59–65

  14. 14.

    Andreoli SP, Yum MN, Bergstein JM (1986) IgA nephropathy in children: significance of glomerular basement membrane deposition of IgA. Am J Nephrol 6:28–33

  15. 15.

    Donadio JV Jr, Offord KP (1989) Reassessment of treatment results in membranoproliferative glomerulonephritis with emphasis on life-table analysis. Am J Kidney Dis 14:445–451

  16. 16.

    Watson AR, Poucell S ThornerP, Arbus GS, Rance CP, Baumal R (1984) Membranoproliferative glomerulonephritis type I in children: correlation of clinical features with pathologic subtypes. Am J Kidney Dis 4:141–146

  17. 17.

    Habib R, Kleinknecht C, Gubler MC, Levy M (1973) Idiopathic membranoproliferative glomerulonephritis in children. Report of 105 cases. Clin Nephrol 1:194–214

  18. 18.

    McEnery PT, McAdams AJ, West CD (1986) The effect of prednisone in a high-dose, alternate-day regimen on the natural history of idiopathic membranoproliferative glomerulonephritis. Medicine (Baltimore) 64:401–424

Download references

Author information

Correspondence to Jerry M. Bergstein.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Bergstein, J.M., Andreoli, S.P. Response of type I membranoproliferative glomerulonephritis to pulse methylprednisolone and alternate-day prednisone therapy. Pediatr Nephrol 9, 268–271 (1995). https://doi.org/10.1007/BF02254181

Download citation

Key words

  • Membranoproliferative glomerulonephritis
  • Treatment
  • Corticosteroids
  • Nephrotic syndrome