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Updated: Jul 3, 2026

Intravascular Delivery of Biologics to the Rat Kidney

Intravascular Delivery of Biologics to the Rat Kidney

Published on: September 1, 2016

Interventions for renal vasculitis in adults.

Giles Walters¹, Narelle S Willis, Jonathan C Craig

¹Renal Department, The Canberra Hospital, PO Box 11, Woden, ACT, Australia, 2606. Giles.Walters@act.gov.au

The Cochrane Database of Systematic Reviews

|July 23, 2008

Summary

Plasma exchange effectively reduces end-stage kidney disease in renal vasculitis patients. Continuous cyclophosphamide (CPA) is preferred over pulse CPA to prevent relapses, while azathioprine (AZA) aids maintenance therapy.

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Last Updated: Jul 3, 2026

Intravascular Delivery of Biologics to the Rat Kidney

Intravascular Delivery of Biologics to the Rat Kidney

Published on: September 1, 2016

Area of Science:

Nephrology
Immunology
Rheumatology

Background:

Renal vasculitis, presenting as rapidly progressive glomerulonephritis (RPGN), leads to acute kidney failure (AKF), hematuria, and proteinuria.
Standard treatments include steroids and non-steroid agents, often combined with plasma exchange.
Despite successful immunosuppression, optimal dosing, duration, and the role of plasma exchange require clarification.

Purpose of the Study:

To evaluate the benefits and harms of various interventions for treating renal vasculitis in adults.

Main Methods:

A systematic review of randomized controlled trials was conducted.
Searches included Cochrane CENTRAL, Cochrane Renal Group Specialised Register, MEDLINE, and EMBASE.
Data were independently assessed, with statistical analyses using random effects models.

Main Results:

Plasma exchange significantly reduced the risk of end-stage kidney disease (ESKD) at 3 and 12 months.
Pulse cyclophosphamide (CPA) increased remission rates but also relapse risk compared to continuous CPA.
Azathioprine (AZA) showed no outcome difference but reduced leukopenia; antibiotics were ineffective for preventing Wegener's relapse.

Conclusions:

Plasma exchange is effective for severe acute renal failure (ARF) due to vasculitis.
Continuous CPA is favored over pulse CPA for reduced relapse risk, though pulse CPA involves a lower total dose.
Cotrimoxazole may prevent vasculitis relapse, and AZA is effective for maintenance therapy post-remission.