Plasma exchange treatment improves prognosis of antineutrophil cytoplasmic antibody-associated crescentic glomerulonephritis: a case-control study in 26 patients from a single center

Ther Apher Dial. 2003 Dec;7(6):540-6. doi: 10.1046/j.1526-0968.2003.00089.x.


Twenty-six patients with Antineutrophil cytoplasmic antibody (ANCA)-associated crescentic glomerulonephritis (GN) were divided into two groups according to the acute phase treatment: drug therapy consisting of steroids and oral cyclophosphamide plus a plasma exchange (PE) course (group A, 13 patients) or drug therapy alone (group B, 13 patients). Group A patients had a more severe clinical picture and higher serum creatinine than group B (12.7 +/- 6.9 vs. 8.5 +/- 5.3 mg%); nine patients from group A (69%) and five from group B (38%) required dialysis. At follow up (mean 35 months) all patients treated with PE were alive: four of them were in end-stage renal disease. Among group B patients, three (23%) died in the acute phase; 6 (46%) needed renal replacement therapy at follow up. Of the dialysis-dependent patients, five out of nine from group A were free of dialysis, while in group B two out of five patients had died, two had entered a regular dialysis treatment and one had received a cadaver graft. These data suggest that PE may significantly improve the prognosis of patients with ANCA-associated crescentic GN even if they are not dialysis-dependent at the time of diagnosis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Antibodies, Antineutrophil Cytoplasmic / analysis
  • Antibodies, Antineutrophil Cytoplasmic / immunology*
  • Case-Control Studies
  • Chi-Square Distribution
  • Female
  • Follow-Up Studies
  • Glomerulonephritis, Membranoproliferative / immunology
  • Glomerulonephritis, Membranoproliferative / mortality
  • Glomerulonephritis, Membranoproliferative / therapy*
  • Granulomatosis with Polyangiitis / immunology
  • Granulomatosis with Polyangiitis / mortality
  • Granulomatosis with Polyangiitis / therapy*
  • Humans
  • Kidney Function Tests
  • Male
  • Middle Aged
  • Plasma Exchange / methods*
  • Probability
  • Risk Assessment
  • Severity of Illness Index
  • Sex Factors
  • Survival Rate
  • Treatment Outcome


  • Antibodies, Antineutrophil Cytoplasmic