Because of the risk of adverse effects, corticosteroids should probably be reserved for patients with any of the following: Worsening or persistent proteinuria (> 1 g / day), especially if in the nephrotic range despite maximal ACE inhibitor or ARB therapy Increasing serum creatinine level Combinations of IV corticosteroids and cyclophosphamide plus oral prednisone are used for severe disease, such as proliferative or crescentic (rapidly progressive) nephropathy.