Pulmonary renal syndrome and emergency therapy

The pulmonary renal syndrome is a symptom complex with simultaneous involvement of the kidneys and lungs. While this can be related to any concomitant kidney and lung dysfunction, the usual connotation is that of kidney dysfunction associated with pulmonary hemorrhage frequently manifesting as hemoptysis. Many causes of the pulmonary renal syndrome have been defined, and therapy is directed at the underlying etiologic factor for the syndrome. At times the presentation is life-threatening. In those situations emergency therapy must be initiated as soon as possible. A number of therapies are now available for this syndrome including pulse methylprednisolone and plasmapheresis. Emerging novel therapies show promise of augmenting the armamentarium of the clinician's therapeutic options. This review addresses the author's approach to the elaboration of the etiology of pulmonary renal syndrome and the therapeutic options available to the clinician.