Sustained Remission of Membranous Glomerulonephritis after Cyclophosphamide and

Objective: To determine the effect of cyclophosphamide and prednisone on progressive renal failure and on nephrotic features in patients with membranous glomerulonephritis. Design: Prospective, nonrandomized time series. Setting: Outpatient clinic at a university medical center. Patients: Eleven consecutive patients with biopsy-proven mem-branous glomerulonephritis and rising plasma creatinine levels over at least 6 months. Intervention: Cyclophosphamide and prednisone in ten patients and cyclophosphamide alone in one patient. Measurements and Main Results: In ten patients treated with both agents, the median plasma creatinine rose 53 /umol/L (0.6 mg/dL) over the months before treatment from 141 to 194 /nmol/L (1.6 to 2.2 mg/dL) (95 % CI, 27 to 141 fimol/L; P = 0.002). After combined therapy for 6 months, the median plasma creatinine fel