Course, by increasing the observation period the likelihood of spontaneous remission increases (although less and less common as time goes by), as well as that of specific complications from nephrotic syndrome and renal function deterioration. viagra canada For this reason, in those cases with sustained massive proteinuria, not showing a decreasing trend and with bad tolerance to the nephrotic syndrome, it may be reasonable to shorten the observation period to 6-9 months3 and decide on specific therapeutic measures, that we will discuss later on. generic viagra canada Aggressive forms of mgn those cases initiating a rapid deterioration of renal function, almost always associated with massive proteinuria, should be excluded from the previous concept of conservative observation. Similarly to what happens with spontaneous remissions, it is within the first 12-24 months from diagnosis when these aggressive forms present. buy generic viagra on line Before establishing this diagnosis, it is necessary to rule out that renal function deterioration is due to other functional factors (abuse of diuretics, collateral effect of aceis/ara, etc. are viagra and viagra the same ). viagra sildenafil 50mg side effects Although there are no controlled prospective studies specifically aimed at these patients, we do have available studies on historical cohorts showing a very poor prognosis in those cases not receiving immunosuppressive therapies, as compared with treated ones. does viagra affect young men 9, 10 in our experience, 9 virtually all the historical non-treated cases progressed to end-stage rf or died, whereas in treated cases the renal survival rate at 8 years reached 90%. buy viagra What kind of immunosuppressive therapy is preferred in these aggressive forms? The most popular immunosuppressive regimen for mgn is, with no doubt, that from ponticelli’s group, based on high-dose steroids (odd months) alternating with chlorambucil (even months), for 6 months. 2 we have used a regimen similar to ponticelli’s, although simplified by administering steroids exclusively p. viagra online without prescription O. does viagra affect young men (prednisone 1 mg/kg/day) with progressive reduction of the chlorambucil dose during 6 months, (0. cheap viagra online 15 mg/kg/day) for the first 14 weeks. 9 other authors p. woman in the viagra commercial does viagra affect young men