AZATHIOPRINE IN GLOMERULONEPHRITIS: A Long-term Study

Abstract Nineteen patients with proliferative glomerulonephritis, treated with azathioprine and prednisone with apparent encouraging results, have been followed up, and the results of similar treatment of a further sixteen patients have been evaluated. An attempt was made to correlate clinical and morphological status of the patients with the duration of disease before therapy, the mode of presentation, and the duration of therapy. Patients were followed up to 5 years. Favourable responses were observed only in patients with clinical and morphological findings similar to patients who frequently spontaneously recover without therapy. Relapses or permanent loss of functioning renal tissue was not associated with discontinuation of treatment. Patients with chronic glomerulonephritis or the nephrotic syndrome associated with glomerulonephritis did not show improvement with combined azathioprine and prednisone, and in most cases renal function deteriorated during therapy. Patients apparently improving in the early stages showed severe deterioration on follow-up despite continued treatment. In these studies there was no apparent advantage to the use of azathioprine and prednisone in glomerulonephritis.