Application Effect of Dual Plasma Exchange in Rapidly Progressive Glomerulonephritis

Liu Mengmeng; Zang Haoliang

doi:10.3969/j.issn.1004-5775.2025.18.013

Abstract：Objective:To investigate the clinical efficacy of dual plasma exchange in the treatment of rapidly progressive glomerulonephritis.Methods:Retrospective collection of data on 59 patients with type I rapidly progressive glomerulonephritis admitted to The Fourth People's Hospital of Shangqiu from October 2019 to October 2022.According to different treatment methods,they were divided into study group(n=23)and control group(n=36).The control group received intensive plasma exchange combined with methylprednisolone shock and cyclophosphamide treatment,while the study group received dual plasma exchange combined with methylprednisolone shock and cyclophosphamide treatment.Both groups received continuous treatment for 4 weeks.The baseline data questionnaire was designed by the researchers,and the general data of the two groups were collected.The efficacy,time to symptom resolution,renal function indices,and adverse reactions were compared between two groups.Results:After completing the 4-week treatment protocol,the cumulative response rate in the experimental cohort exceeded that of the control group,with statistically signifieant difference(χ2=3.904;P＜0.05).The study group had shorter blood pressure stability,edema resolution,and hematuria disappearance time than control group,with statistically signifieant difference(t=2.660,2.700,3.723;P＜0.05).Both groups showed a decrease in 24-hour urinary protein quantification,cystatin C,and serum creatinine,with the study group being lower,with statistically signifieant difference(t=4.268,4.740,10.242;P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion:Therapeutic approach integrating dual plasma exchange and cyclophosphamide administration in the treatment of rapidly progressive glomerulonephritis can significantly improve clinical efficacy,accelerate clinical symptom recovery,and effectively improve renal function.The safety is good.