| Theme | The initiation and maintenance of dialysis in terms of original kidney diseases and complications | |
|---|---|---|
| Title | Vasculitis and anti-GBM disease | |
| Publish Date | 2014/08 | |
| Author | Shinya Kaname | First Department of Internal Medicine (Nephrology and Rheumatology), Kyorin University School of Medicine |
| [ Summary ] | In patients with ANCA-associated vasculitis (AAV) resulting in incident dialysis, renal function may improve through continued immunosuppressive therapy before the initiation of dialysis. However, after 3 months on dialysis, immunosuppressive therapy should be stopped in consideration of the risk of infection unless there are complications due to systemic symptoms such as pulmonary bleeding. Thus, maintenance therapy is not recommended for dialysis patients with AAV even if ANCA titers are positive. However, the possibility of relapse increases in ANCA-positive patients. Thus early diagnosis and treatment are desired. Strict management of infection is necessary in dialysis patients having had relapses and receiving immunosuppressive therapy. In patients with anti-GBM disease resulting in initiation of dialysis, relapses are rare once anti-GBM antibodies become negative after initial treatment. Thus, after several months of initial therapy, no maintenance therapy is required. |
|