Plasma Exchange Is Highly Effective for Anti‐Neutrophil Cytoplasmic Antibody‐Associated Vasculitis Patients With Rapidly Progressive Glomerulonephritis Who Have Advanced to Dialysis Dependence: A Single‐Center Case Series

Plasma exchange (PEX) can be an effective treatment in anti‐neutrophil cytoplasmic antibody‐associated vasculitis with severe renal damage; however, it is still controversial. Among cases of newly diagnosed AAV with rapidly progressive glomerulonephritis at our department from 2008 onward, 11 patients who received PEX (seven cases for severe renal damage [R‐PEX] and four cases for lung hemorrhage [L‐PEX]) were retrospectively analyzed. All cases of R‐PEX were dependent on hemodialysis at the beginning of PEX and all received seven sessions of PEX (50 mL/kg or 1.3 plasma volume per exchange) within 2 weeks. All cases became dialysis‐independent within 8 weeks, with 3‐ and 12‐month cumulative renal survival rates of 100% and 80%, respectively. All cases of L‐PEX retained their renal function. In rapidly developing, newly dialysis‐dependent antibody‐associated vasculitis with rapidly progressive glomerulonephritis patients with normal renal function before disease onset, standard PEX can be expected to induce sufficient renal recovery to establish dialysis independence.