Prognosis after immunosuppression of patients with crescentic nephritis requiring dialysis

Abstract

48 patients with rapidly progressive glomerulonephritis were treated by a regimen of intensive plasma exchange, steroids, and cytotoxic drugs. All required dialysis before immunosuppressive treatment was started, and all had 50% or more of their glomeruli affected by crescent formation. Renal function was not recovered in any of the 21 patients with anti-glomerular basement membrane antibody disease. In contrast 63% of patients without these autoantibodies recovered renal function. Plasma creatinine remained stable over prolonged follow-up (6-60 months) in all but 1 of the 10 late survivors. There was no correlation between the extent of crescent formation and recovery of renal function in those patients without circulating anti-glomerular basement membrane antibodies.