The authors present their long standing experience with immunosuppressive treatment of patients with nephrotic syndrome associated with primary chronic membranous, mesangioproliferative and mesangiocapillary glomerulonephritis. Of a total of 127 patients 99 were treated with prednisone and cyclophosphamide and 28 with cyclophosphamide only. Clinical remission developed in 89 patients (70%). Remissions developed independently on morphological findings and initial proteinuria, but more frequently in patients with a still normal glomerular filtration. In combined immunosuppression 77% of the treated patients developed remission, while only 48% treated with cyclophosphamide alone. 88% of the patients survive an average period of 10 years. From the investigation it is apparent that long-term and early combined immunosuppression has a favourable impact on the course of primary chronic glomerulonephritis with nephrotic syndrome.

2 interní klinika 1 LF UK Praha