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Efficacy of plasma exchange in severe idiopathic rapidly progressive glomerulonephritis. A report of ten cases
Author(s) -
Burran W. P.,
Avasthi P.,
Smith K. J.,
Simon T. L.
Publication year - 1986
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.1986.26486262750.x
Subject(s) - rapidly progressive glomerulonephritis , medicine , immunosuppression , renal function , basement membrane , glomerular basement membrane , dialysis , disease , glomerulonephritis , surgery , gastroenterology , kidney , pathology
The vast majority of patients with idiopathic rapidly progressive glomerulonephritis (RPGN) develop irreversible renal failure within weeks to months. We report a retrospective study of 10 patients with idiopathic RPGN who were treated with plasma exchange in addition to steroids and immunosuppression. Renal biopsies were obtained in nine patients. RPGN without immune complexes was present in four, immune complex disease in four, and anti‐glomerular basement membrane disease in two. Renal function did not recover in those patients with anti‐glomerular basement membrane disease. In contrast, seven of eight patients without auto‐antibodies to basement membranes responded to therapy, and four did not need dialysis for two years or more. The sustained improvement in renal function in these seven patients suggests the need for evaluation of plasma exchange as an adjunct to steroids and immunosuppression in a prospective, controlled study in RPGN.