Prolonged intermittent steroid therapy for nephrosis in children and adults.

Abstract

Aqueous ACTH, to induce diuresis, was given for at least 12 but preferably for 21 days, unless marked side-effects necessitated earlier cessation of therapy, to patients with nephrosis and clinical and laboratory findings consisting of massive edema, marked proteinuria (3+ to 4+), hypoproteinemia, hyperlipemia, and, in most instances, a lowering of the serum complement activity. Prolonged intermittent therapy with cortisone, given orally, was begun five days after the onset of diuresis but only when diuresis led to complete freedom from edema. After one year, therapy was gradually terminated by prolonging the intervals between maintenance courses rather than by decreasing the daily dosage. Prolonged intermittent steroid therapy not only resulted in an improved prognosis but also permitted the patients to live a more gainful and happy life. The growth and development of these children has remained within normal limits during and after prolonged intermittent maintenance therapy. Continuous steroid therapy, in contrast, has resulted in marked developmental disturbances.