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Treatment of crescentic glomerulonephritis
Author(s) -
BOLTON W KLINE
Publication year - 1995
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.1995.tb00038.x
Subject(s) - medicine , immunosuppression , rapidly progressive glomerulonephritis , glomerulonephritis , methylprednisolone , disease , vasculitis , glomerular basement membrane , intensive care medicine , acute glomerulonephritis , immunology , kidney
Summary: Acute crescentic‐rapidly progressive glomerulonephritis is an uncommon but devastating disease which comes in several forms. That associated with anti‐glomerular basement membrane (GBM) antibodies is most vexing to treat and has by far the worst prognosis. Despite conventional wisdom that plasma exchange and immunosuppression are optimal therapy, the cost constraints and issues raised in the present review suggest that this needs to be readdressed. Non‐anti‐GBM disease appears to respond well to aggressive immunosuppression and/or plasma exchange. A possible zided benefit of plasma exchange in patients with vasculitis on dialysis needs to be further addressed, especially in terms of a possible differential effect of very large doses of pulse methylprednisolone (30 mg/kg) as opposed to smaller doses.