Treatment of mesangiocapillary glomerulonephritis in children with combined immunosuppression and anticoagulation

Abstract

10 children with mesangiocapillary (membranoproliferative) glomerulonephritis with features associated with a poor prognosis (either crescentic nephritis or a decline in renal function occurring after the initial presentation) were treated with a combination of immunosuppression and anticoagulation using corticosteroids, azathioprine, and heparin followed by warfarin and dipyridamole. Children were followed up for between 2 and 5 years, and at the end of this period 2 had died and 2 had entered the dialysis/transplant programme, but 6 were well (5 with glomerular filtration rates greater than 65 ml/min per 1 x 73 m2). We suggest that these results are sufficiently promising to encourage further trials of this form of treatment.