Treatment and prognosis of extracapillary glomerulonephritis

The results reviewed here seem to indicate the following guidelines for the treatment of ECGN: (1) oliguric ECGN: plasma exchange or 'pulse' therapy or a combination of the two, in combination with other immunosuppressive therapy seems to be more effective than any other therapy, and it is hardly ethical to deny patients such treatment. The available evidence cannot distinguish between the effectiveness of these two therapies: (2) non-oliguric ECGN: the value of immunosuppressive therapy in this group of patients must be accepted as proven, but there is no evidence that plasma exchange or 'pulse' therapy gives added benefit.