1997•Therapeutic Apheresis and DialysisRequires access
Plasmapheresis in the Treatment of Rapidly Progressive Glomerulonephritis
Takashi Harada, Y Ozono, Masanobu Miyazaki, Osamu Sasaki, Kenichi Miyazaki, Katushige Abe, Junko Nagashima, Shoko Tukazaki, Takashi Shioshita, Hiroshi Ichinose, Ryosuke Shimamine, Yasuhiko Nishikawa, Masaharu Nishikido, K Yamaguchi, Shigeru Kohno, Takashi Taguchi
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Abstract
The present study was carried out to examine the efficacy of plasma exchange in patients with rapidly progressive glomerulonephritis (RPGN). Seventeen patients with RPGN were treated with plasmapheresis as adjunct to immunosuppressive therapy. Of these, 4 had antiglomerular basement membrane (GBM) antibody-mediated glomerulonephritis (GN), 8 had immune-complex GN (5 SLE, 2 HSP, 1 cryoblobulinemia), 5 had pauci-immune GN (3 peripheral antineutrophil cytoplasmic antibody [P-ANCA], 1 cytoplasmic antineutrophil cytoplasmic antibody [C-ANCA], 1 other). Treatment of 10 of these patients with plasmapheresis within the first month of disease onset resulted in a stable renal function for a period extending from 1 to 3 years, except in 2 patients who had high baseline levels of serum creatinine. In the remaining patients, 2 were treated with hemodialysis 6 years later at the end of follow-up. We conclude that plasmapheresis, when used in combination with immunosuppressive drugs, is beneficial, leading to improved renal function.