A retrospective study compared two groups with type IV lupus nephritis with very similar activity and chronicity indices on renal biopsy. One group was treated with intermittent pulse cyclophosphamide (IPC), and the other was not. The IPC group demonstrated a greater decrease in serum creatinine at 6 months, 12 months and most recent follow-up intervals (p < 0.01, p < 0.05, p < 0.001). Reduction in proteinuria was similar in the two groups. Two of eight in the no-IPC group progressed to ESRD while only one of twelve in the IPC group developed ESRD. The findings suggest that IPC preserves renal function in Type IV nephritis. Furthermore it is suggested that a lower cumulative dosage than previously reported may reduce toxicity without a significant loss of efficacy.
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