Plasmapheresis and peritoneal dialysis in the management of rapidly progressive glomerulonephritis

Six patients with rapidly progressive glomerulonephritis were given plasmapheresis and peritoneal dialysis by manual technique. At the start of treatment the patients were in renal failure and all but two were practically anuric. Renal biopsy revealed glomerular sclerosis in 4 cases. One of the patients in whom segmental focal fibrosis was found, went into remission. In the other three cases extensive hyaline degeneration was present. One of them was placed on a dialysis program, two died with circulatory failure. In two cases no glomerular sclerosis was found, though extensive changes of the tissues were present. One of these patients went into remission, the other died from respiratory failure consequent upon recurrent pneumothorax and gross pulmonary infiltration. The only chance of success in the management of rapidly progressive glomerulonephritis is offered by the earliest possible diagnosis. In cases of glomerular sclerosis the chances are very poor.