0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Diagnosis and Treatment |

Idiopathic Nephrotic Syndrome: Puncturing the Biopsy Myth

ANDREW S. LEVEY, M.D.; JOSEPH LAU, M.D.; STEPHEN G. PAUKER, M.D.; and JEROME P. KASSIRER, M.D.
[+] Article and Author Information

Presented in part at the 5th annual meeting of the Society of Medical Decision Making, Toronto, Canada, 2 to 4 October 1983, and at the 16th annual meeting of the American Society of Nephrology, Washington, D.C, 4 to 7 December 1983.

▸Requests for reprints should be addressed to Andrew S. Levey, M.D.; Nephrology Division, New England Medical Center Hospitals, 750 Washington Street, Box 784; Boston, MA 02111.


Boston, Massachusetts


©1987 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1987;107(5):697-713. doi:10.7326/0003-4819-107-5-697
Text Size: A A A

We used decision analysis to compare the conventional strategy of biopsy-tailored therapy with alternative strategies not using renal biopsy in treating adults with idiopathic nephrotic syndrome. We evaluated data on steroid and platelet-inhibitor therapies and a new clinical strategy, empiric sequential therapy. This sequential approach involves use of short-term alternate-day steroid agents, followed by long-term platelet inhibitors for persistent nephrotic syndrome. Our results indicate that, contrary to usual practice, use of renal biopsy is not necessary in caring for adult patients with idiopathic nephrotic syndrome; empiric short-term alternate-day steroid therapy is equally efficacious. If the benefits of platelet-inhibitor therapy for treating membranoproliferative glomerulonephritis are confirmed, empiric sequential therapy also will be equally efficacious. Our study shows how decision analysis can be used to identify superfluous diagnostic procedures.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)