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Sökning: WFRF:(Gaskin Gill) > (2005-2009) > Randomized trial of...

LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00003856naa a2200433 4500
001oai:lup.lub.lu.se:0c18d0a7-6fb1-4429-aeb2-f79fd936e46a
003SwePub
008160401s2007 | |||||||||||000 ||eng|
0247 a https://lup.lub.lu.se/record/6915952 URI
0247 a https://doi.org/10.1681/ASN.20070100902 DOI
040 a (SwePub)lu
041 a engb eng
042 9 SwePub
072 7a art2 swepub-publicationtype
072 7a ref2 swepub-contenttype
1001 a Jayne, David R. W.4 aut
2451 0a Randomized trial of plasma exchange or high-dosage Methylprednisolone as adjunctive therapy for severe renal vasculitis
264 1c 2007
520 a Systemic vasculitis associated with autoantibodies to neutrophil cytoplasmic antigens (ANCA) is the most frequent cause of rapidly progressive glomerulonephritis. Renal failure at presentation carries an increased risk for ESRD and death despite immunosuppressive therapy. This study investigated whether the addition of plasma exchange was more effective than intravenous methylprednisolone in the achievement of renal recovery in those who presented with a serum creatinine > 500 mu mol/L (5.8 mg/dl). A total of 137 patients with a new diagnosis of ANCA-associated systemic vasculitis confirmed by renal biopsy and serum creatinine > 500 mu mol/L (5.8 mg/dl) were randomly assigned to receive seven plasma exchanges (n = 70) or 3000 mg of intravenous methylprednisolone (n = 67). Both groups received oral cyclophosphamide and oral prednisolone. The primary end point was dialysis independence at 3 mo. Secondary end points included renal and patient survival at 1 yr and severe adverse event rates. At 3 mo, 33 (49%) of 67 after intravenous methylprednisolone compared with 48 (69%) or 70 after plasma exchange were alive and independent of dialysis (95% confidence interval for the difference 18 to 35%; P = 0.02). As compared with intravenous methylprednisolone, plasma exchange was associated with a reduction in risk for progression to ESRD of 24% (95% confidence interval 6.1 to 41%), from 43 to 19%, at 12 mo. Patient survival and severe adverse event rates at 1 yr were 51 (76%) of 67 and 32 of 67 (48%) in the intravenous methylprednisolone group and 51 (73%) of 70 and 35 of (50%) 70 in the plasma exchange group, respectively. Plasma exchange increased the rate of renal recovery in ANCA-associated systemic vasculitis that presented with renal failure when compared with intravenous methylprednisolone. Patient survival and severe adverse event rates were similar in both groups.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Urologi och njurmedicin0 (SwePub)302142 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Urology and Nephrology0 (SwePub)302142 hsv//eng
7001 a Gaskin, Gill4 aut
7001 a Rasmussen, Niels4 aut
7001 a Abramowicz, Daniel4 aut
7001 a Ferrario, Franco4 aut
7001 a Guillevin, Loic4 aut
7001 a Mirapeix, Eduardo4 aut
7001 a Savage, Caroline O. S.4 aut
7001 a Sinico, Renato A.4 aut
7001 a Stegeman, Coen A.4 aut
7001 a Westman, Kerstinu Lund University,Lunds universitet,Njurmedicin,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Nephrology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine4 aut0 (Swepub:lu)njur-kwe
7001 a van der Woude, Fokko J.4 aut
7001 a van Wijngaarden, Robert A. F. de Lind4 aut
7001 a Pusey, Charles D.4 aut
7102 a Njurmedicinb Sektion II4 org
7730 t Journal of the American Society of Nephrologyg 18:7, s. 2180-2188q 18:7<2180-2188x 1046-6673
8564 u http://dx.doi.org/10.1681/ASN.2007010090y FULLTEXT
8564 8u https://lup.lub.lu.se/record/691595
8564 8u https://doi.org/10.1681/ASN.2007010090

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