DIFFERENCE BETWEEN RENAL-FAILURE ASSOCIATED WITH METHYLPREDNISOLONE PULSE THERAPY AND DETERIORATION OF RENAL-FUNCTION UNRELATED TO METHYLPREDNISOLONE THERAPY

In this study, we attempted to analyze the differences between renal f ailure associated with methylprednisolone (MP) pulse therapy and natur al deterioration of renal function that was unrelated to MP administra tion. Of 80 patients with renal or collagen disease who received MP pu lse therapy at our hospitals, 13 were selected for the study whose ser um creatinine levels increased more than 0.5 mg/dl from baseline value s following therapy. Somewhat arbitrarily, 7 patients were placed in a n MP-associated renal deterioration group (group 1) in which serum cre atinine levels returned naturally, or following induced diuresis, to b aseline levels, and 6 patients in an MP-independent natural deteriorat ion group (group 2) in which renal function progressively deteriorated . Renal function similarly deteriorated in the two groups following pu lse therapy, irrespective of the degree of crescent formation. Our dat a suggested that hypoproteinemia is the most important index for diffe rentiating MP-associated renal failure from natural deterioration of r enal function unrelated to MP pulse therapy. In patients that are neph rotic and have impaired renal function, worsening of renal function fo llowing pulse therapy may partly be due to transient MP-associated ren al failure. On the other hand, in patients without hypoproteinemia, wo rsening of renal function is most likely due to active primary disease and is probably not associated with MP pulse therapy.