Figure 1124

Change in chronicity index in repeat biopsies after treatment with prednisone (PRED) alone or prednisone and cytotoxic drugs (CTD). The addition of cytotoxic drugs to the treatment regimen of patients with World Health Organization (WHO) class III or IV nephritis clearly improves renal and patient survival [56,57]. The pathophysiologic basis for this beneficial effect is illustrated, displaying the change in chronicity index between the first and second kidney biopsies over time. As can be seen during prednisone monotherapy, there is a clear increase of the chronicity index (A);

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