Rapidly progressing glomerulonephritis in patients with ANCA-associated vasculitis: natural history, efficacy of treatment and prognostic
Abstract
19 patients (12 men, 7 women) with ANCA-associated vasculitis and with morphological pictures of pauciimmune rapidly progressive glomerulonephritis were analyzed retrospectively. All patients received immunosuppressive therapy including a combination of cyclofosfamide and prednisolone (intravenous and oral). In 15 of 19 patients the therapy was successful as judged from a decrease in serum creatinine level from 790 (400; 1025) to 200 (120; 320) µmol/l and in proteinuria level from 0,9 (0,5; 2,2) to 0,16 (0,06; 0,8) g/day. Renal recovery in pauciimmune rapidly progressive glomerulonephritis did not depend on clinical manifestations of ANCA-associated vasculitis, level of renal insufficiency or extracapillary proliferation. The main predictor of patient’s response to the therapy was severity of glomerulosclerosis. In this case only a partial remission of renal disease could be achieved.
About the Authors
E. T. Egorova
ФГУ «НИИ трансплантологии и искусственных органов» Росмедтехнологий, кафедра нефрологии ФПДО МГМСУ
Russian Federation
Russian Federation
N. A. Tomilina
ФГУ «НИИ трансплантологии и искусственных органов» Росмедтехнологий, кафедра нефрологии ФПДО МГМСУ
Russian Federation
Russian Federation
L. S. Birukova
ФГУ «НИИ трансплантологии и искусственных органов» Росмедтехнологий, кафедра нефрологии ФПДО МГМСУ
Russian Federation
Russian Federation
A. V. Sukhanov
ФГУ «НИИ трансплантологии и искусственных органов» Росмедтехнологий, кафедра нефрологии ФПДО МГМСУ
Russian Federation
Russian Federation
E. S. Stoliarevich
ФГУ «НИИ трансплантологии и искусственных органов» Росмедтехнологий, кафедра нефрологии ФПДО МГМСУ
Russian Federation
Russian Federation
O. A. Kupavtseva
Лаборатория клинической иммунологии ГУ «НИИ ревматологии РАМН», г. Москва
Russian Federation
Russian Federation
N. D. Fedorova
Московский городской нефрологический центр, ГКБ № 52
Russian Federation
Russian Federation
L. G. Kurenkova
ФГУ «НИИ трансплантологии и искусственных органов» Росмедтехнологий, кафедра нефрологии ФПДО МГМСУ
Russian Federation
Russian Federation
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Review
For citations:
Egorova E.T., Tomilina N.A., Birukova L.S., Sukhanov A.V., Stoliarevich E.S., Kupavtseva O.A., Fedorova N.D., Kurenkova L.G. Rapidly progressing glomerulonephritis in patients with ANCA-associated vasculitis: natural history, efficacy of treatment and prognostic. Nephrology and Dialysis. 2007;9(3):228-239. (In Russ.)
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