Rapidly progressive glomerulonephritis in anca-associated vasculitis: a course, treatment efficacy, prognosis


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Abstract

Aim. To study efficacy of ANCA-RPGN treatment with corticosteroids and cyclophosphamide or mycophenolic acid drugs. Material and methods. We treated 28patients (17 males and 11 females aged 19-71 years) with morphologically verified ANCA-associated crescentic RPGN (crescentic median 79 (63:88)%. The patients received corticosteroids and cytostatics. Results. The response to the treatment was registered in 22 (78%) patients in 8-16 weeks: a complete remission was achieved in 8 patients, a partial one - in 14 patients. In partial remission renal functions recovered incompletely (median Pсr 200 (180;255) mcmol/l) in persistence of moderate proteinuria (median 0.7 (0.6;1.3)g/day) and absence of microhematuria. Probability of the treatment success depended on severity of glomerulosclerosis and weakly depended on activity of extracapillary reaction. Severe renal failure was not an absolute predictor of treatment failure. Conclusion. In the absence of advanced nephrosclerosis early treatment with corticosteroid in combination with cytostatics can produce a positive effect in 70-80% patients with ANCA associated RPGN.

About the authors

N A Tomilina

ФГУ НИИ трансплантологии и искусственных органов Росмедтехнологий РФ; МГМСУ

L S Biriukova

ФГУ НИИ трансплантологии и искусственных органов Росмедтехнологий РФ; МГМСУ

E T Egorova

ФГУ НИИ трансплантологии и искусственных органов Росмедтехнологий РФ; МГМСУ

A V Sukhanov

ФГУ НИИ трансплантологии и искусственных органов Росмедтехнологий РФ; МГМСУ

E S Stoliarevich

ФГУ НИИ трансплантологии и искусственных органов Росмедтехнологий РФ; МГМСУ

O A Kupavtseva

ГУ НИИ ревматологии РАМН, Москва

N D Fedorova

ФГУ НИИ трансплантологии и искусственных органов Росмедтехнологий РФ; МГМСУ

A V Frolov

Московский городской нефрологический центр, ГКБ № 52, Москва

R N Trushkin

Московский городской нефрологический центр, ГКБ № 52, Москва

L G Kurenkova

ФГУ НИИ трансплантологии и искусственных органов Росмедтехнологий РФ; МГМСУ

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