Combined Anticoagulant and Immunosuppressive Treatment in Rapidly Progressive Glomerulonephritis (RPGN).

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  • NAKAMOTO Yasushi
    the First Department of Internal Medicine, School of Medicine, Kanazawa University
  • DOHI Kazuhiro
    Division of Medicine, National Kanazawa Hospital
  • FUJIOKA Masahiko
    the First Department of Internal Medicine, School of Medicine, Kanazawa University
  • KIDA Hiroshi
    the First Department of Internal Medicine, School of Medicine, Kanazawa University
  • HATTORI Nobu
    the First Department of Internal Medicine, School of Medicine, Kanazawa University
  • TAKEUCHI Jugoro
    The Second Department of Internal Medicine, Tokyo Medical and Dental University

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  • A Long-Term Follow-up Study

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Twenty-four cases with primary and secondary RPGN were divided into three groups according to the type of treatment ; group 1 received anticoagulants, steroids and cytotoxic drugs (8 cases), group 2 received steroids and immunosuppressives alone (10) and group 3 had neither form of treatment (6). Doses of immunosuppressives were same in group 1 and 2. All cases in group 3 died of uremia within the first 2 years. Six of 8 cases in group 1 (75%) and 4 of 10 in group 2 (40%) survived beyond 2 years, with variable recovery of function. Although statistically not significant, the combined regimen appeared to accelerate histological improvement. Cases with already advanced glomerular changes failed to respond. Gradual decline of a previously improved GFR was occasionally observed after withdrawal of treatment. Nevertheless, the survivors have not required hemodialysis for 4 to 8 years.

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