Deterioration of Renal Function after Discontinuation of Long-Term Prednisone-Azathioprine Therapy in Primary Renal Disease

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Abstract
Three adult patients receiving long-term prednisone-azathioprine therapy for primary renal disease resistant to prednisone alone demonstrated severe abrupt deterioration in renal function when this combined therapy was stopped. The drugs were discontinued after periods of one to three years because continuing proteinuria in all and a slowly falling creatinine clearance in two suggested that they were ineffective. In retrospect it appeared that they were maintaining relative stability of a disease that in their absence became rapidly progressive. Reinstitution of therapy failed to halt the progression in one but reversed it in the other two.