| Theme | Designated intractable kidney diseases：The control in non-dialysis CKD and renal replacement therapy | |
|---|---|---|
| Title | ANCA associated vasculitis and anti-GBM antibody glomerulonephritis | |
| Publish Date | 2016/04 | |
| Author | Takashi Iwakiri | Department of Internal Medicine, Faculty of Medicine, University of Miyazaki |
| Author | Shouichi Fujimoto | Department of Hemovascular Medicine and Artificial Organs, Faculty of Medicine, University of Miyazaki |
| [ Summary ] | ANCA associated vasculitis (AAV) and anti-GBM antibody related nephritis are syndromes which present as rapidly progressive nephritic syndrome, requiring corticosteroids and immunosuppressive agent therapy for the induction and remission. Recently, the efficacy of rituximab for AAV has been exhibited. However, careful judgment of indications is needed because of opportunistic infections. The KDIGO guidelines recommend no maintenance therapy for patients who are dialysis dependent and have no extrarenal manifestations of disease. On the other hand, the recurrence rate of vasculitis has been reported to be 0.03-0.27/patient per year after the induction of dialysis. Strengthening immunosuppressive therapy with agents such as methylprednisolone pulse therapy, immunosuppressants, plasma exchange or rituximab is recommended after vasculitis relapse. | |