Author/Editor		Rychlik, I; Tesar, V; Stejskalova, A; Žabka, J; Merta, M; Bartunkova, J
Title		Repeated renal biopsy in patients with Wegener's granulomatosis and microscopic polyangiitis - contribution to prognosis and treatment
Type		članek
Source		In: Lindič J, Kaplan-Pavlovčič S, editors. Zbornik prispevkov 1. slovenski nefrološki kongres z mednarodno udeležbo; 1996 okt 23-26; Portorož. Ljubljana: Klinični center, Nefrološka klinika,
Publication year		2000
Volume		str. 33-6
Language		eng
Abstract		Despite of successful experience with cyclophosphamide treatment of acute phase of ANCA associated vasculitides, the long time treatment and the monitoring of disease activity, e. g. through ANCA levels, remain unclear. Nineteen patients with biopsy proven active ANCA positive renal vasculitis were treated for one year with conventional combined immunosuppression using oral continuous prednisone (initial dose 0.75 mg/kg of bw) and oral continuous cyclophosphamide (initial dose 2.0 mg/kg bw, tapered to 50 mg daily during three months). 14 patients received also 3 x 0.5 g intravenous pulses of methylprednisolone at the beginning of therapy. The second renal biopsy was done in all patients after one year. Clinical remission was induced in all patients. In comparison of both renal histology findings epithelial crescents were rare in effectively treated patients, only 1/3 of affected glomeruli were spare by immunosuppressive treatment, sclerotic lesions increased and serum creatinine concentration and percentage of crescents in time of presentation was related. The long-term prognosis of renal function seems to be determined especially by the number of fibrous crescents and the extent of interstitial fibrosis in the second renal biopsy.
Descriptors		KIDNEY DISEASES ANTIBODIES, ANTINEUTROPHIL CYTOPLASMIC WEGENER'S GRANULOMATOSIS VASCULITIS PREDNISONE METHYLPREDNISOLONE TREATMENT OUTCOME BIOPSY