Effect of intravenous cyclophosphamide pulse therapy in patients with proliferative lupus nephritis

Background: Lupus nephritis, especially diffuse proliferative type is one of the potentially life threatening disabling consequences of SLE that needs intensive and invasive treatment. As there is not enough information available about the results of Intravenous Cyclophamide (IVC) therapy on these patients in our country, this study was performed from ۱۹۹۷ to ۲۰۰۲ in Esfahan Azzahra Hospital. Materials and Methods: In this semi-experimental study ۱۴ hospitalized patients with Diffuse Proliferative Glomerulonephritis (DPGN) were treated with IVC, and the efficacy of IVC was investigated by evaluation of urine sediment, serum urea, creatinin, and urinary excretion of creatinin and protein. The results were evaluated after ۶,۱۲ and ۲۴ months of IVC therapy again. All of the data were analyzed by paired t-test and Chi - square test. Results: ۳ patients were excluded and ۱۴ patients were studied. Partial remission was seen in ۵ patients (۳۳.۴%) after ۶ months, and in one patient (۷.۱%) after ۱۲ months of IVC therapy. There was not any cases of partial remission after ۲۴ months of treatment. The rate of complete remission in ۶th, ۱۲th and ۲۴th months of study were ۱۴.۳%, ۲۸.۶% and ۲۸.۶%. The cumulative frequency of complete remission cases in ۶th, ۱۲th and ۲۴th months of study were ۱۴.۳%, ۴۲.۹% and ۷۱.۴%. In general, only ۳ (۲۱.۴%) cases continued to have proteinuria in the range of nephrotic syndrome after ۲۴ months of treatment. The average interval to achieve partial remission was ۷.۷ ۲.۹ months and for complete remission was ۱۵.۶ ۷.۵۹ months. Conclusion: Most cases with diffuse proliferative lupus nephritis achieved complete remission after ۲ years (۷۱.۴%) of IVC therapy. So we recommend this treatment for all patients with lupus induced diffuse proliferative glumerolonephritis.

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KEYWORDS: Systemic Lupus Erytematosis ، Cyclophosphamide ، Proliferative Lupus Nephritis ، واژگان کلیدی: سیستمیک لوپوس اریتماتوز ، سیکلوفسفامید وریدی ، نفریت لوپوسی پرولیفراتیو