Comparison of Low vs. High Dose Pulsed Methylprednisolone on Proteinuria in Lupus Nephritis
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Abstract
Background: Lupus Nephritis (LN) is a serious complication of systemic lupus erythematosus, with proteinuria being a predominant clinical challenge. The use of glucocorticoids, particularly Methylprednisolone, is established in the management of LN. However, the precise dosing that ensures optimal outcomes is still under investigation.
Objective: This study aimed to ascertain the efficacy and safety profile of low versus high dose pulsed Methylprednisolone in ameliorating proteinuria in Lupus Nephritis patients.
Methods: A comparative cohort study was conducted involving LN diagnosed patients aged between 18 and 60 years, excluding those with other comorbid renal conditions or prior high-dose steroid treatments. Participants were segregated into two groups receiving either low or high dose pulsed Methylprednisolone. Proteinuria levels, serum creatinine, blood sugar levels, and blood pressure were monitored at specified intervals. Data were analysed using the SPSS 25.0 software, employing t-tests for continuous variables.
Results: The high dose group exhibited a pronounced reduction in proteinuria (from 3346.95±547.12 mg/24hr at baseline to 267.84±43.83 mg/24hr at 3 months) and serum creatinine (from 2.05±0.79 mg/dl at baseline to 1.12±0.43 mg/dl at 3 months). However, a notable increase in blood sugar levels was observed (from 115.65±7.89 mg/dl at baseline to 136.95±9.38 mg/dl at 3 months). No significant variation in blood pressure was recorded in either cohort.
Conclusion: High dose Methylprednisolone offers superior proteinuria reduction, but the concurrent rise in blood sugar emphasizes the need for a judicious, individualized therapeutic approach. The findings advocate for a harmonized strategy, balancing renal benefits against potential adverse outcomes.
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