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Nephrol Dial Transplant (2002) 17: 16-18
© 2002 European Renal Association-European Dialysis and Transplant Association

IV.2.5 Late recurrence of primary glomerulonephritides

Guidelines

A. In the case of recurrent focal and segmental glomerulosclerosis (FSGS), aggressive treatment with high-dose cyclosporine in children, ACE inhibitors and/or Angiotensin II antagonists, plasma exchange or immunoadsorption may result in remission in some patients.

(Evidence level B)

B. In the case of recurrent membranous nephropathy (MN), there is no specific treatment. However, control of risk factors, such as hypertension, heavy proteinuria and hyperlipidaemia, and prevention of thrombotic complications are recommended.

(Evidence level C)

C. In the case of recurrent membranoproliferative glomerulonephritis (MPGN), there is no specific treatment. However, control of risk factors, such as hypertension, heavy proteinuria and hyperlipidaemia, and prevention of thrombotic complications are recommended.

(Evidence level C)

D. In the case of recurrent IgA glomerulonephritis, use of additional steroids is not yet a validated treatment. The control of risk factors, such as hypertension, heavy proteinuria and hyperlipidaemia, is recommended.

(Evidence level C)

E. In the rare case of recurrent anti-glomerular basement membrane (anti-GBM) glomerulonephritis with reappearance of anti-GBM antibodies, it is recommended to initiate plasma exchange and to treat with appropriate immunosuppressive agents (e.g. cyclophosphamide).

(Evidence level C)

See also Guidelines in Part 1.


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