Flores J C, Taube D, Savage C O, Cameron J S, Lockwood C M, Williams D G, Ogg C S
Lancet. 1986 Jan 4;1(8471):5-8. doi: 10.1016/s0140-6736(86)91893-3.
Eight patients with oligoanuric anti-glomerular-basement-membrane (GBM), antibody-mediated glomerulonephritis without lung haemorrhage who were not treated with plasma exchange therapy were reviewed. All had severe crescentic nephritis and required dialysis. Circulating anti-GBM antibodies disappeared gradually and spontaneously in all patients. The autoantibodies became undetectable in five patients after an average of 11 months. No patient recovered renal function. Two patients have been successfully transplanted and anti-GBM nephritis has not recurred. One of these needed a pre-transplant course of plasma exchange and immunosuppression to reduce a slightly raised anti-GBM antibody titre. Of five patients who remain on dialysis, only two cannot be transplanted due to the persistence of circulating autoantibodies. One patient died from causes unrelated to renal disease. Oligoanuric patients with anti-GBM nephritis who need dialysis rarely benefit from aggressive therapy unless lung haemorrhage is present.
对8例无肺出血的少尿型抗肾小球基底膜（GBM）抗体介导的肾小球肾炎患者进行了回顾性研究，这些患者未接受血浆置换治疗。所有患者均患有严重的新月体性肾炎且需要透析。所有患者循环抗GBM抗体均逐渐自发消失。平均11个月后，5例患者的自身抗体检测不到。无患者肾功能恢复。2例患者已成功移植，抗GBM肾炎未复发。其中1例患者移植前需要进行血浆置换和免疫抑制治疗，以降低略升高的抗GBM抗体滴度。在仍接受透析的5例患者中，只有2例因循环自身抗体持续存在而无法进行移植。1例患者死于与肾脏疾病无关的原因。少尿型抗GBM肾炎且需要透析的患者，除非存在肺出血，否则很少能从积极治疗中获益。
