Rapid Progressive Glomerulonephritis: Drug Therapy

Therapeutic targets

  • Edema elimination (flushing out water retention).
  • Avert the deterioration of renal function

Therapy recommendations

  • Treatment of the underlying disease (if known)
  • Induction therapy: methylprednisolone (glucocorticoids); cycophosphamide (alkylants) + mesna; after 6 months, switch to relapse prophylaxis (measures to prevent recurrence of disease)
  • Relapse prophylaxis: azathioprine (purine analogues), mycophenolate mofetil, methotrexate (MTX, folic acid antagonist).
  • Plasmapheresis (plasma exchange for effective removal of unwanted antibodies) possibly additionally as a rescuetherapy (life-prolonging therapy; in type 1 RPNG).
  • Anuria (lack of urine output; maximum 100 ml/24 h) may require (temporary) dialysis (blood purification).
  • See also under “Further therapy“.