The First Stage
On the first day of hospitalization (May 4), intravenous methylprednisolone (40 mg) was administrated. SCr continued to increase to 319 μmol/L the following day (May 5). From May 5 through 7 (3 days), a higher dose of methylprednisolone (80 mg per day) was used. The patient felt better, with improved appetite and urine color. The therapy was adjusted to intravenous methylprednisolone (40 mg per day) and a regimen of intravenous cyclophosphamide (CTX) at a fixed dose of 400 mg on 2 consecutive days (May 8 and 9).