Guidance
Some kidney disease ditatalaksana proteinurik children with puls therapy, among others: class IV lupus nephritis or proliferative lupus nephritis difus, systematic lupus erythematosus temik Infantile, glomerulosklerosis focal segmental (GS-FS), membranoprolifetarif glomerulonephritis type I, Henoch-Schonlein purpura nephritis heavy, heavy glomerulonephritis, nephrotic syndrome and steroid survive.
Way
Medications are often used in therapy puls is metilprednisolon dose 15-30 mg / kgbb / day and cyclo-fosfamid 500-1000 mg / kgbb / day.
There are many ways giving puls therapy.
1. Metilprednisolon
a. Metilprednisolon with a dose of 30 mg / kgbb (maximum 1500 mg) was dissolved in 50-100 ml dekstrose 5%, given by infusion for 1 hour or can be for 6 hours. As long as the necessary monitoring of vital signs, especially blood pressure and heart frequency. Puls therapy is given every other day three times a week on weeks 1 and 2. During weeks 3 to 10 methyl-prednisolone 30 mg / kgbb given once a week, week 11 to 18 metilprednisolon 30 mg / kgbb given every 2 weeks, at week 19 to 50 metilprednisolon 30 mg / kgbb given every 4 weeks, and during the week 51 up to 82 metilprednisolon 30
mg / kgbb given every 8 weeks. Starting week three with oral doses given prednison 2 mg / kgbb / day every other day and week eleven prednison down slowly until week 82.
If the treatment is improvement of living there, so drugs are not given alkilating. Alkilating drug is given if there has been a persistent nephrotic proteinuri after 10 weeks of treatment metilprednisolon puls or if initially there is improvement, but accompanied by an increase proteinuri means. Cyclo-fosfamid usually given 2 to 2.5 mg / kgbb / day or klorambusil 0.2 mg / kgbb / day for 8-12 weeks.
b. Puls Metilprednisolon 1000 mg / 1.73 m2 LPB provided with the help of infusion pumps in 6 hours 3 times every other day. After it was given 30 mg/m2 prednison LPB every day for a month, then 30 mg / m2 per-day intervals LPB for 2 months, and 15 mg/m2 LPB every other day for 2 weeks. Empowerment series
puls metilprednisolon can be extended to 8 months to 4 years, depending on the clinical symptoms of disease.
c. Bergstein and Andreoli (1995) gave methyl-prednisolone puls 30 mg / kgbb / dose (maximum 1.5 g) infused intravenously in 50-100 ml of liquid dekstrose 5% for 30-60 minutes, is given every day 6 times followed by prednison 2 mg / kgbb / day (maximum 60 mg / day) single dose every other day for an average of 37 months (12-66 months) or prednison 2 mg / kgbb / day for 1 month and to then, slowly revealed. (8,10,17) Termination of treatment depends on the stability of the clinical disease.
2. Siklofosfamid
a. Siklofosfamid LPB 500 mg/m2 in 250 ml NaCl 0.9%, given by infusion slowly within 3-4 hours to reduce the risk of nausea and vomiting. In addition to being organized is also giving an oral liquid with a large number of 24 hours and often advisable to reduce the risk of new bladder hemoragik reefs. Puls Siklofosfamid given every month for six months. LPB Prednison 60 mg/m2 given every day for two months, followed by a grant every other day
(Alternate days) for 4 months, and a further dose 30 mg/m2 LPB every other day for 6 months. One year after the initial dose intravenous and prednison siklofosfamid, steroids down slowly 10 mg per month, and stopped in 2-6 months, depending on the initial dose.
b. Puls Siklofosfamid given in 100-150 ml dekstrose 5% for 1 hour followed by hydration with 5% in the infusion dekstrose NaCl 0.5% 2 l/m2 LPB given for 24 hours. After the initial grant, siklofosfamid puls given every month for 6 months and up to 7 doses and was continued every 3 months to 3 years. At the beginning of cyclo-fosfamid given dose of 500 mg/m2 LPB, LPB increased to 750 mg/m2 to 1000 mg / m2 LPB.
c. Puls Siklofosfamid dose of 750 mg/m2 given by LPB. After therapy siklofosfamid puls, patients received intravenous hydration for 24 hours and organized frequent bladder. Puls siklofosfamid Initially given every 1-2 months depending on disease activity. Dose reduced if klirens creatinine <40 ml / min. After a dose of a total of 6 times, the treatment stopped if there is no active form of the disease. This dose can be extended up to 2 or 3 times 6 doses. Prednison 1 mg / kgbb / day given every day for 6 weeks, then reduced to 40 mg and 20 mg every other day.
Some kidney disease ditatalaksana proteinurik children with puls therapy, among others: class IV lupus nephritis or proliferative lupus nephritis difus, systematic lupus erythematosus temik Infantile, glomerulosklerosis focal segmental (GS-FS), membranoprolifetarif glomerulonephritis type I, Henoch-Schonlein purpura nephritis heavy, heavy glomerulonephritis, nephrotic syndrome and steroid survive.
Way
Medications are often used in therapy puls is metilprednisolon dose 15-30 mg / kgbb / day and cyclo-fosfamid 500-1000 mg / kgbb / day.
There are many ways giving puls therapy.
1. Metilprednisolon
a. Metilprednisolon with a dose of 30 mg / kgbb (maximum 1500 mg) was dissolved in 50-100 ml dekstrose 5%, given by infusion for 1 hour or can be for 6 hours. As long as the necessary monitoring of vital signs, especially blood pressure and heart frequency. Puls therapy is given every other day three times a week on weeks 1 and 2. During weeks 3 to 10 methyl-prednisolone 30 mg / kgbb given once a week, week 11 to 18 metilprednisolon 30 mg / kgbb given every 2 weeks, at week 19 to 50 metilprednisolon 30 mg / kgbb given every 4 weeks, and during the week 51 up to 82 metilprednisolon 30
mg / kgbb given every 8 weeks. Starting week three with oral doses given prednison 2 mg / kgbb / day every other day and week eleven prednison down slowly until week 82.
If the treatment is improvement of living there, so drugs are not given alkilating. Alkilating drug is given if there has been a persistent nephrotic proteinuri after 10 weeks of treatment metilprednisolon puls or if initially there is improvement, but accompanied by an increase proteinuri means. Cyclo-fosfamid usually given 2 to 2.5 mg / kgbb / day or klorambusil 0.2 mg / kgbb / day for 8-12 weeks.
b. Puls Metilprednisolon 1000 mg / 1.73 m2 LPB provided with the help of infusion pumps in 6 hours 3 times every other day. After it was given 30 mg/m2 prednison LPB every day for a month, then 30 mg / m2 per-day intervals LPB for 2 months, and 15 mg/m2 LPB every other day for 2 weeks. Empowerment series
puls metilprednisolon can be extended to 8 months to 4 years, depending on the clinical symptoms of disease.
c. Bergstein and Andreoli (1995) gave methyl-prednisolone puls 30 mg / kgbb / dose (maximum 1.5 g) infused intravenously in 50-100 ml of liquid dekstrose 5% for 30-60 minutes, is given every day 6 times followed by prednison 2 mg / kgbb / day (maximum 60 mg / day) single dose every other day for an average of 37 months (12-66 months) or prednison 2 mg / kgbb / day for 1 month and to then, slowly revealed. (8,10,17) Termination of treatment depends on the stability of the clinical disease.
2. Siklofosfamid
a. Siklofosfamid LPB 500 mg/m2 in 250 ml NaCl 0.9%, given by infusion slowly within 3-4 hours to reduce the risk of nausea and vomiting. In addition to being organized is also giving an oral liquid with a large number of 24 hours and often advisable to reduce the risk of new bladder hemoragik reefs. Puls Siklofosfamid given every month for six months. LPB Prednison 60 mg/m2 given every day for two months, followed by a grant every other day
(Alternate days) for 4 months, and a further dose 30 mg/m2 LPB every other day for 6 months. One year after the initial dose intravenous and prednison siklofosfamid, steroids down slowly 10 mg per month, and stopped in 2-6 months, depending on the initial dose.
b. Puls Siklofosfamid given in 100-150 ml dekstrose 5% for 1 hour followed by hydration with 5% in the infusion dekstrose NaCl 0.5% 2 l/m2 LPB given for 24 hours. After the initial grant, siklofosfamid puls given every month for 6 months and up to 7 doses and was continued every 3 months to 3 years. At the beginning of cyclo-fosfamid given dose of 500 mg/m2 LPB, LPB increased to 750 mg/m2 to 1000 mg / m2 LPB.
c. Puls Siklofosfamid dose of 750 mg/m2 given by LPB. After therapy siklofosfamid puls, patients received intravenous hydration for 24 hours and organized frequent bladder. Puls siklofosfamid Initially given every 1-2 months depending on disease activity. Dose reduced if klirens creatinine <40 ml / min. After a dose of a total of 6 times, the treatment stopped if there is no active form of the disease. This dose can be extended up to 2 or 3 times 6 doses. Prednison 1 mg / kgbb / day given every day for 6 weeks, then reduced to 40 mg and 20 mg every other day.
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