Treatment of idiopathic acute crescentic glomerulonephritis by immunodepression and plasma-exchanges. A prospective randomised study

Abstract

A prospective randomised trial was carried out in 14 patients with severe 'idiopathic' acute crescentic glomerulonephritis. The mean percentage of crescents was 78 per cent and 11 patients were anuric at presentation. Eight patients received pulses of methylprednisolone, immunosuppressive drugs and anticoagulants and six the same therapeutic regimen plus plasma exchanges for one to two months. Mean follow-up was 22 months. Recovery was statistically better in the PE+ group (p less than 0.02), but for discontinuation of dialysis, the difference is significant only at two months (p less than 0.02), perhaps because of the small number of patients. For this reason and because all pathological subgroups cannot be analysed separately, this study is continuing.