Survey of Japanese nephrologists' use of clinical practice guidelines for rapidly progressive glomerulonephritis.
Clin Exp Nephrol
; 28(4): 316-324, 2024 Apr.
Article
in En
| MEDLINE
| ID: mdl-38151607
ABSTRACT
BACKGROUND:
The guidelines in Japan for the treatment of rapidly progressive glomerulonephritis (RPGN) have been revised; the latest update was released in 2020. We investigated the actual usage of the new guidelines in Japan.METHODS:
We distributed a survey electronically to board-certified nephrologists throughout Japan from December 15, 2021 to January 31, 2022. The survey focused on anti-neutrophil cytoplasmic antibody (ANCA)-associated RPGN and anti-glomerular basement membrane (GBM)-antibody RPGN, plus the treatment strategies and infection-prevention measures used.RESULTS:
The survey was completed by 155 certified nephrologists from medical facilities across Japan. Their responses regarding treatment procedures revealed that ANCA-associated RPGN was treated with immunosuppressants and/or biologics by 58.1% of the survey respondents, and with plasma exchange (PE) in combination with corticosteroids by 21.3%. Regarding anti-GBM-antibody RPGN, 78.1% of the respondents used corticosteroids in combination with PE (63.2%), cyclophosphamide (CY) (23.9%), or rituximab (RTX) (8.4%), suggesting a discrepancy between clinical practice and the actual use of the guidelines. Trimethoprim-sulfamethoxazole was prescribed as prophylaxis by 94.8% of the respondents, reflecting the widespread recognition of the need to prevent infectious disease in patients with RPGN.CONCLUSIONS:
The survey responses revealed how Japan's new RPGN guidelines are used in actual clinical practice. Our findings will contribute to the guidelines' dissemination and implementation.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Glomerulonephritis
/
Nephritis
Limits:
Humans
Country/Region as subject:
Asia
Language:
En
Journal:
Clin Exp Nephrol
Journal subject:
NEFROLOGIA
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: