Management of idiopathic crescentic and diffuse proliferative glomerulonephritis: Evidence-based recommendations

摘要: Management of idiopathic crescentic and diffuse proliferative glomerulonephritis: Evidence-based recommendations. Idiopathic glomerulonephritis (GN) often presents with a rapid loss renal function pathology showing extensive crescent formation. The disease is caused by different immunopathogenetic mechanisms, pauci-immune, antineutrophil cytoplasmic antibody (ANCA)-positive microvasculitis, anti-glomerular basement membrane (GBM) disease, immune complex Historical reviews reveal poor prognosis, even after treatment oral steroids cytotoxic drugs. Prognosis has improved in the last decade. In this article, evidence-based recommendations for management are presented. Because high risk end-stage (ESRD), early aggressive therapy recommended, despite weak supporting evidence. Treatment anti-GBM antibody-induced GN should be initiated include pulse methylprednisolone, two-week course plasmapheresis two months corticosteroids cyclophosphamide (grade B C). pauci-immune followed 6 to 12 B). Recurrences can managed similarly B), along appropriate supportive therapy. patients who develop ESRD, successful transplantation performed. Diffuse endocapillary classically postinfectious. It generally good prognosis when no formation occurs. Adult persistent proteinuria, hypertension, impairment need careful follow-up modify progressive hemodynamic injury.