Description
The treatment of renal disease in ANCA-associated vasculitis (AAV) typically involves a combination of immunosuppressive therapies to control inflammation and prevent further kidney damage. First-line treatment often includes high-dose corticosteroids and cyclophosphamide or rituximab, both of which help to induce remission by targeting the underlying immune system dysfunction. In cases of kidney failure or rapidly progressive glomerulonephritis, plasmapheresis may be used to remove circulating autoantibodies. Once remission is achieved, maintenance therapy with lower doses of immunosuppressants, such as azathioprine or mycophenolate mofetil, is used to prevent relapses and preserve kidney function.
Summary Listen
- The speaker discusses Anca-associated vasculitis, a clinical topic frequently encountered. The presentation covers a case study, definition of Anca (anti-neutrophil cytoplasmic antibody) and vasculitis, classification of vasculitis, diagnosis and identification of Anca-associated vasculitis.
- Diagnosis of Anca-associated vasculitis relies on both clinical and pathological evidence. It is suspected based on clinical syndrome, and biopsy of the involved organ is the most straightforward method of establishing a diagnosis. There are multiple diagnostic tests suggestive of vasculitis.
- The speaker discusses the Chappelhale classification for classification of systemic vasculitis and predominantly Anca associated vasculitis has these three particular diseases. The first one is granulomatosis with polyenjaities. The second one is microscopic polyenjaities which is short-formed as MPA. The third one is church straw syndrome.
- There are guidelines suggested by KDGO for diagnosing oncalae associated renal disease. If a patient presents with a decline in kidney function, you do a urinalysis and if there is a dysdipstic positive for protein or blood further workup and evaluate for oncalae and also do kidney biopsy.
- Treatment guidelines include glucocorticoid or evacocorticoid, cyclophosphamide and retoximab. Retoxtimab is preferred in children and woman and old adults. Cyclophosphamide is preferred for severe cases with creatinine more than 4 mg.
- Maintenance therapy options like retoximab, azarthiobrine, or micro phenolate are chosen based on the patient's clinical response and renal function. The speaker also mentions a new drug called abacupan which blocks C5A.
- The speaker talks about using Retoximab. The standard dose for retoximab is 375 milligram per square either four weekly dose or you can use one gram every fortnight for two doses. For maintenance, you can use retoximab 500 milligram every six months.
Sample Certificate
About the Speakers
Dr. Amitabh Kulkarni
Head of Department, Nephrology, NMC Speciality Hospital, Dubai
Financial Disclosure
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