A follow-up study of nephrotic children treated initially with pulse therapy

We tried to evaluate the long-term effect of pulse therapy on children with idiopathic naphrotic syndrome (INS). Thirteen cases of INS with minimal or mild proliferative changes, treated initially with pulse therapy, were followed up for 2 to 5 years. Additional oral steroids were not administered as initial therapy in these cases. The evaluation was based on the later courses in relation to the initial effect (the length of elimination of proteinuria) after the therapy. One patient had no relapse after the initial pulse therapy. In two of three cases in which an initial effect lasted for more than 1 month, relapse did not occur after 1 or 2 years from the onset. In six cases in which an initial effect lasted for less than 1 month, and in one of three who showed no response to the initial pulse therapy, relapse did not occur after 1 to 3 years from the onset. In other cases, relapse frequently occured throughout the follow-up period (for 4 to 5 years). In all of these cases, responsiveness to steroid and the renal function were preserved all over the courses. hese results show that the pulse therapy without additional oral steroid has no adverse effect on prognosis. Pulse therapy may be used as the initial therapy for INS of children.