TREATMENT OF NEPHROSIS WITH CORTISONE 12

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Abstract
Admn. of cortisone (0.5-2.1 g. total over 5-16 days) to 11 patients with the nephrotic syndrome gave the following results: during treatment, proteinuria was moderately accentuated, and the excretion of Na fell to very low levels. Creatinine clearance was usually increased. The serum albumin and protein concns. rose slightly. In 2 cases, treatment was stopped because of a rising serum K concn. After the end of admn. of cortisone the patients followed 1 of 2 patterns: 6 patients lost all edema and had a reduction in proteinuria varying from slight to almost complete disappearance of protein from the urine. Serum protein and albumin concns. were increased to nearly normal levels in 2 cases. Improvement was variable in duration from days to months. 5 patients showed no clinical benefit, no increase in Na excretion, and no decrease in proteinuria. Patients who responded with a diuresis showed a decrease in the high level of Na-retaining corticoids in the urine; a higher avg. creatinine clearance, which increased further during and after treatment; a higher avg. serum Na concn. at the end of treatment, rising to normal after diuresis; no difference in avg. total protein or albumin concns. before or at the end of admn. of cortisone, but much greater improvement after subsequent diuresis and lessening of proteinuria. 4 of the 5 patients who showed no clinical benefit after cortisone, lost their edema when concd. human serum albumin was given. Admn. of albumin was followed by: a reduction in the high level of Na-retaining corticoids in the urine; a further increase in creatinine clearance; an increase in the serum Na concn.