Crescentic glomerulonephritis is a rapidly progressive renal disease with a high risk of development of end-stage renal failure within a few weeks or months of onset. The choice and effectiveness of therapy are controversial. High-dose pulse methylprednisolone is widely preferred for treatment of crescentic glomerulonephritis at the present time, but its efficacy is acknowledged to be less than ideal in preserving renal function. Our study is designed to test the efficacy of intensive, intermittent immunosuppressive drug therapy in patients with crescentic glomerulonephritis over a 6 month study period. Patients with renal biopsy documented active crescentic glomerulonephritis will be treated with a short course of oral corticosteroids and randomized to receive in addition: (a) intravenous methylprednisolone monthly for 6 months, or (b) intravenous cyclophosphamide monthly for 6 months. Comparisons will be made of the number of favorable outcomes of renal function and renal pathology, as well as drug-related toxicities for each treatment group.
