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Plasma Exchange Is Highly Effective for Anti‐Neutrophil Cytoplasmic Antibody‐Associated Vasculitis Patients With Rapidly Progressive Glomerulonephritis Who Have Advanced to Dialysis Dependence: A Single‐Center Case Series
Author(s) -
Nishida Reimi,
Kaneko Shuzo,
Usui Joichi,
Kawamura Tetsuya,
Tsunoda Ryoya,
Tawara Takashi,
Fujita Akiko,
Nagai Kei,
Kai Hirayasu,
Morito Naoki,
Saito Chie,
Yamagata Kunihiro
Publication year - 2019
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12830
Subject(s) - medicine , rapidly progressive glomerulonephritis , dialysis , hemodialysis , vasculitis , gastroenterology , glomerulonephritis , renal function , single center , kidney , immunology , disease
Plasma exchange (PEX) can be an effective treatment in anti‐neutrophil cytoplasmic antibody‐associated vasculitis with severe renal damage; however, it is still controversial. Among cases of newly diagnosed AAV with rapidly progressive glomerulonephritis at our department from 2008 onward, 11 patients who received PEX (seven cases for severe renal damage [R‐PEX] and four cases for lung hemorrhage [L‐PEX]) were retrospectively analyzed. All cases of R‐PEX were dependent on hemodialysis at the beginning of PEX and all received seven sessions of PEX (50 mL/kg or 1.3 plasma volume per exchange) within 2 weeks. All cases became dialysis‐independent within 8 weeks, with 3‐ and 12‐month cumulative renal survival rates of 100% and 80%, respectively. All cases of L‐PEX retained their renal function. In rapidly developing, newly dialysis‐dependent antibody‐associated vasculitis with rapidly progressive glomerulonephritis patients with normal renal function before disease onset, standard PEX can be expected to induce sufficient renal recovery to establish dialysis independence.