Differences between membranoproliferative glomerulonephritis types I and III in long-term response to an alternate-day prednisone regimen
American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
M C BraunC F Strife
Membranoproliferative glomerulonephritis (MPGN) is classified as type I, II, or III based on ultrastructural alterations in the glomerular basement membrane. Whereas type II has long been recognized as clinically and pathologically unique, types I and III are often difficult to distinguish and have not been separated in most clinical studies. We compared the course and long-term outcome of patients with types I and III MPGN followed up at this institution since 1960. During this period, 21 patients with type I and 25 patients with type III were followed up for a minimum of 5 years. Patients with types I and III MPGN did not differ in age at apparent onset, age at diagnosis, or interval from apparent onset of symptoms to diagnosis (biopsy). They had similar initial serum C3 and serum albumin levels. Patients with type I had a significantly lower initial mean estimated glomerular filtration rate (GFR(est)) compared with those with type III (99.1 +/- 35.9 versus 131.6 +/- 36. 1 mL/min/1.73 m(2); P < 0.01). Type and duration of therapy, length of follow-up, and frequency of complications of therapy did not differ between groups. There was, however, a significant difference in duration of hypocomplementemia. After 1 year of an alter...Continue Reading
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