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Rasch progrediente Glomerulonephritis. Spontanverlauf und Differentialtherapie unter besonderer Berücksichtigung der Infektions-assoziierten Form

Clinical course of rapidly progressive glomerulonephritis during immunosuppression, plasmaseparation and without specific therapy

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Summary

Since 1971 we observed 31 patients with histologically proven rapidly progressive (crescentic) glomerulonephritis. At the onset of therapy 16 patients presented with end stage renal failure, the others with impaired renal function. 21 patients received combined immunosuppressive therapy, consisting of prednisone, cyclophosphamide and azathioprine. 8 patients were treated with membrane plasmapheresis, additionally. 10 patients received no specific therapy. After 5 years 13 patients were on hemodialysis, 4 had impaired renal function and 10 patients were dead. Two patients died due to the progression of underlying diseases, the others were lost following infectious diseases. There was no additional positive effect in the group treated with membrane plasma separation compared with patients treated only immunosuppressive. Only in 4 patients without specific therapy normalization of renal function occurred. In these patients RPGN appeared after an infectious disease. We conclude that an infectious disease associated RPGN is an own entity of glomerulonephritis that has a very good prognosis and needs only antibiotic therapy.

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Abbreviations

RPGN:

Rasch progrediente Glomerulonephritis

OB:

ohne spezifische Therapie

IS:

Immunsuppression

PS:

Plasmaseparation

LE:

Lupus erythematodes

Literatur

  1. Alwall N, Erlanson P, Tornberg A (1958) Two cases of acute glomerular nephritis with severe oliguria or anuria for 75 days. Acta med scand 161:85–89

    Google Scholar 

  2. Arieff AI, Pinggera WF (1972) Rapidly progressive glomerulonephritis treated with anticoagulans. Arch Intern Med 129:77–84

    Google Scholar 

  3. Bacani RA, Velasquez F, Kanter A, Pirani C, Pollak VE (1968) Rapidly progressive (nonstreptococcal) glomerulonephritis: Ann Intern Med 69/3:463–485

    Google Scholar 

  4. Beirne GJ, Wagnild JP, Zimmermann SW, Macken PD, Burkholder PM (1977) Idiopathic crescentic glomerulonephritis. Medicine 56/5:349–381

    Google Scholar 

  5. Berlyne GM, Baker SB (1964) Acute anuric glomerulonephritis. Quart J med 33:105–111

    Google Scholar 

  6. Blumenstein M, Samtleben W, Habersetzer R, Gurland HJ (1982) Plasma-Austausch bei Nierenerkrankungen. Dtsch med Wochenschr 107:1854–1856

    Google Scholar 

  7. Blumenstein M, Gokel JM, Samtleben W, Thoenes GH (1981) Rapid progressive Glomerulonephritis bei einem jungen Mann mit günstigem Verlauf. Internist 22:649–652

    Google Scholar 

  8. Bohle A (1984) Glomerulonephritiden Gruppe III. Mesangioproliferative Glomerulonephritis mit diffuser Halbmondbildung (rapid-progressive Glomerulonephritis). In: Bohle, Gärtner, Laberke, Kruck (Hrsg) Die Niere, 1. Ausgabe. Schattauer, Stuttgart New York, 196–218

    Google Scholar 

  9. Bolton WK, Couser WG (1979) Intravenous pulse methylprednisolone therapy of acute crescentic rapidly progressive glomerulonephritis. Am J Med 66:495–502

    Google Scholar 

  10. Girndt J, Bohle A, Quellhorst E, Scheler F (1972) Akutes Nierenversagen als Ursache einer Oligo-Anurie bei akuter diffuser Glomerulonephritis. Dtsch med Wochenschr 97:266–269

    Google Scholar 

  11. Glassock RJ, Adler SG, Ward HJ, Cohen AH (1986) Primary glomerular diseases. In: Brenner BM, Rector FC (eds) The Kidney, Bd. 1, third edition. WB Saunders, Philadelphia, pp 929–1013

    Google Scholar 

  12. Glöckner WM, Siebert H-G, Wichmann HE et al. (1988) Plasmaexchange and immunsuppression in rapidly progressive glomerulonephritis: a controlled, multi-center study. Clinical Nephrology 29/1:1–8

    Google Scholar 

  13. Habib R (1979) Classification anatomique des nephropathies glomerulaires. Pädiat Fortbild Kurs 28:3–47

    Google Scholar 

  14. Lockwood CM, Rees AJ, Pearson TA, Evans DJ, Peters DK, Wilson CB (1976) Immunosuppression and plasma exchange in the treatment of Goodpasture's syndrome. Lancet 1:711–715

    Google Scholar 

  15. Lockwood CM, Rees AJ, Pinching AJ, Pussell B, Swany P, Uff J, Peters DK (1977) Plasma exchange and immunosuppression in treatment of fulminating immune complex crescentic nephritis. Lancet 1:63–67

    Google Scholar 

  16. Morrin PF, Hinglais N, Nabarra B, Kreis H (1978) Rapidly progressive glomerulonephritis — a clinical and pathologic study. Am J Med 65:446–460

    Google Scholar 

  17. O'Neill WM, Etheridge WB, Bloomer A (1979) High-Dose Corticoids-their use in treating idiopathic rapidly progressive glomerulonephritis. Arch Intern Med 139:514–518

    Google Scholar 

  18. Oredugba O, Debesh C, Mazumdar MB, Meyer JS, Lubowitz H (1980) Pulse Methylpredinsolone therapy in idiopathic, rapidly progressive glomerulonephritis. Ann Int Med 92/4:504–506

    Google Scholar 

  19. Pinggera WF, Djawan S, Singer F, Stummvoll HK, Wolf A (1973) Heparintherapie bei perakuter Glomerulonephritis. Wien Z inn Med 54:417–421

    Google Scholar 

  20. Reichel W, Fischbach H, Quellhorst E, Scheler F (1974) Spontantremission einer rapid progressiven Glomerulonephritis. Dtsch med Wochenschr 99:523–526

    Google Scholar 

  21. Renner E (1982) Rapid progressive Glomerulonephritis. In: Loose H, Renner E (Hrsg) Klinische Nephrologie, Bd. 2, 1. Ausgabe, G Thieme, Stuttgart New York, 71–78

    Google Scholar 

  22. Sieberth H-G, Maurin N (1983) The Therapy of rapidly progressive glomerulonephritis. Klin Wochenschr 61:1001–1010

    Google Scholar 

  23. Sonsino E, Nabarra B, Kazatchkine M (1972) Extracapillary proliferative glomerulonephritis so-called malignant glomerulonephritis. In: Hamburger J, Crosnier J, Maxwell MH (eds) Advances in nephrology, from the Necker Hospital. Chicago, Year Book, Medical Publishers, 2, pp 121–127

    Google Scholar 

  24. Schulz W, Gessler U (1977) Diagnostik, Therapie und Verlauf der rasch progressiven glomerulären Insuffizienz. Therapiewoche 27:7441–7462

    Google Scholar 

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Authors and Affiliations

  1. Abteilung für Nieren- und Hochdruckkranke, Medizinische Klinik, Universitätsklinikum Essen, Hufelandstr. 55, 4300, Essen

    U. Metz-Kurschel, N. Graben & A. Daul

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  1. U. Metz-Kurschel
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  2. N. Graben
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  3. A. Daul
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Metz-Kurschel, U., Graben, N. & Daul, A. Rasch progrediente Glomerulonephritis. Spontanverlauf und Differentialtherapie unter besonderer Berücksichtigung der Infektions-assoziierten Form. Klin Wochenschr 67, 621–626 (1989). https://doi.org/10.1007/BF01718143

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  • DOI: https://doi.org/10.1007/BF01718143

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