Alternate-Day Steroid Therapy in Lupus Nephritis

Six patients with lupus nephritis were treated with a program of alternate-day steroid therapy using doses of 100 or 120 mg of prednisone every other day. Five of the patients had lupus glomerulonephritis; one had lupus glomerulitis. After 6 to 8 months of treatment there was histologic evidence of improvement of the renal lesion in all of the patients. During this time renal function improved in five patients. In one patient with severe lupus glomerulonephritis, creatinine clearance decreased by 30% early in treatment and then become stable. Improvement and stabilization of renal function were maintained after the steroid dosage was subsequently reduced. Beta1C globulin levels were normal after treatment in all of the patients. High-dose steroid therapy given in this way was tolerated very well. The patients remained free of Cushingoid changes and displayed a striking appearance of good health and well-being.