Treatment for<unk>  progressive glomerulonephritis include supportive treatment and specific treatment. Supportive treatment is to treat the infection if there is one, correct the volume status with dialysis if required and smoking cessation. Specific therapy focuses on induction and maintenance of remission. Medical therapy focuses on to induce and then maintain the remission. Two pharmacologic agents used for induction of remission in patients with<unk>  progressive glomerulonephritis are glucocorticoids (high dose) and cyclophosphamide. Cyclophosphamide is necessary to prevent relapse. Azathioprine or methotrexate is used for maintenance therapy. Azathioprine (AZA) is recommended after a 3-month induction period of cyclophosphamide.Indications of plasma exchange include, anti-GBM antibody disease, antineutrophil cytoplasmic antibody (ANCA)-associated<unk>  progressive glomerulonephritis, patients with high risk of renal failure, patients with serum creatinine > 2.3 mg/dL, those patients who do not respond to pharmacologic therapy, and patients diagnosed with pauci-immune crescenteric glomerulonephriits with end stage renal disease and need dialysis. Risk and complications of plasma exchange are transient fall in blood-clotting factors, mild prolongation of prothrombin and activated partial thromboplastin times. Clinically significant bleeding is rare but a coagulation screen should be undertaken before surgery or organ biopsy is performed. Other risks include haematomas at venepuncture/line insertion sites, vasovagal episodes with fainting, fluid overload or under-replacement, and allergic or anaphylactic reactions due to plasma infusion.
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