Comparison of the Therapeutic Effects on the Renal and Life Prognosis in ANCA-associated Nephritis

Abstract

ANCA-associated rapidly progressive glomerulonephritis has been treated with steroid pulse therapy (mPSL pulse), cyclophosphamide pulse therapy (IVCY), rituximab (RTX), and plasma exchange (PE), but the differences in renal and life outcomes are not fully understood. To determine the long-term prognostic impact of plasma exchange in ANCA-associated rapidly progressive glomerulonephritis, we conducted a retrospective observational study with stratification by treatment modality to determine the prognostic impact of plasma exchange in ANCA-associated rapidly progressive glomerulonephritis. Eighty patients with ANCA-associated glomerulonephritis who underwent renal biopsy at our hospital were divided into 5 groups, and the renal and life prognosis were evaluated. IVCY and RTX significantly improved renal survival compared with steroid therapy and PE. PE and PSL oral groups did not improve renal prognosis, but survived without death during the observation period. PE is introduced in patients requiring hemodialysis at biopsy to rapidly reduce ANCA levels with favorable life prognosis.