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Lestariningsih Lestariningsih
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Journal : journal la medihealtico

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Plasma Exchange is a Therapeutic Procedure used in the Management of Rapidly Progressive Glomerulonephritis (RPGN): A Case Report Chekmat, Muh. Dina Tursina; Pratiningrum, Dwi Lestari; Lestariningsih, Lestariningsih; Arwanto, Arwedi; Chasani, Shofa; Nurani, Ayudyah; Setiawan, Budi; Miranti, Ika Pawitra
Journal La Medihealtico Vol. 7 No. 2 (2026): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v7i2.3147

Abstract

Rapidly Progressive Glomerulonephritis (RPGN) is a clinical syndrome characterized by a rapid decline in kidney function and the presence of crescents on kidney biopsy, requiring immediate treatment to prevent disease progression. A 34-year-old man was admitted to the hospital with generalized body swelling that began in the eyelids one week prior. He had a history of fever before admission, which subsided upon hospitalization. Additional complaints included shortness of breath, cough, and runny nose. Past medical history included hypertension and hiperuresemia. In recent days, he experienced oliguria. Physical examination revealed pitting edema in the lower extremities. Laboratory tests showed anemia, hypoalbuminemia, and rapid decline in kidney function. Urinalysis revealed protein +3, leukocytes sediment 80.1/µL, erythrocytes sediment 468/µL, and Esbach 0.5 g/L. Complement C3 53 mg/dL, C4 13.8 mg/dL, ANA, and anti-dsDNA were negative, with no available data for anti-GBM, ANCA and kidney biopsy Segmental Mesangial Hypercellular Glomerulus and focal segmental sclerosis. Chest X-ray showed cardiomegaly, bronchopneumonia, and left pleural effusion. Abdominal ultrasound revealed bilateral parenchymal renal disease. The patient was treated with high dose steroids, antibiotics, antihypertensives, symptomatic medications, two sessions of hemodialysis, and four sessions of plasma exchange (PLEX). The combination therapy of high dose steroids and followed by hemodialysis and plasma exchange, resulted in significant reduction of edema and improvement in kidney function, demonstrating the effectiveness of an aggressive immunomodulatory regimen. In pauci-immune or idiopathic RPGN, the combination of high-dose steroids and plasma exchange along with dialysis provides a rapid clinical response, increases the chance of remission, and preserves kidney function.
Co-Authors Abd. Syakur Afrilia, Tika Fitria Wulan Afroh Fauziah Agung, Fajar Agung Agus Edi Winarto, Agus Edi Agus Mulyanto Setiawan, Agus Mulyanto Ahmad Saifudin, Ahmad Amin, Ahmad Makinul Anifiatiningrum, Anifiatiningrum Anna Lidiyawati Anshori, M Subhan Anshori, Subhan Apriliyanti Apriliyanti Arbi, Anggun Purnomo Arif Muzayin Shofwan, Arif Muzayin Arwanto, Arwedi Atallah, Mukhammad Tsafiq Bachtiar, Aldo Tri Bintarti, Lilik Budi Setiawan Cahyaningrum, Elaesa Putri Indah Chairumin Alfin Chekmat, Muh. Dina Tursina Cholida, Nur Darmawijoyo, Darmawijoyo Dwi Lestari Partiningrum Eli Ermawati Fadilah, Eka Farantika, Dessy Fareza, Mohamad Zulfahmi Al FATRA NONGGALA PUTRA Fauzi, Moh Mimbar Fauzi, Moh. Mimbar Fikriyah, I'anah El Firdaus, Iftinan Nida Hakim, Muhammad Helmi Hartanto, Wido Heri Nugroho Hidayah, Firda Roudlatul Huda, H.M. Dimyati Ika Pawitra Miranti Imam Muchlisin, Mochammad Imam Rofiki Irwani Zawawi Kasanah, Risa Datul Khasanah, Ani Uswatun Khopsoh, Binti khusnul khotimah Kusyanti, Florentina Lailatul Musyarofah, Lailatul Lailatul, Oxsy Lestari, Arum Ayu Lestari, Febbi Senna Lestari, Indah Dewi Lilik Bintartik Lusito, Lusito M. Ridwan M. Zainuddin Mahanani Nugroho, Setyo Mahmudah Mahmudah Makarim, Fadhli Rizal Makrifah, Anisatul Marselina Endah Hiswati Maulidah, Nita Safitri Mere, Jeniati Inka Jaka Moch. Lutfianto Mohammad Zainuddin, Mohammad Muashomah, Muashomah Muhammad Anwar Muhammad Zainuddin Mulyono, Enggal Chairyadi Munawar Munawar Murtadho, Ahmad Rizqi Muti'atussalafi, Muti'atussalafi Mu’minin, Umril Nahdiyah, Umi Nining Haryuni Nisa, Zulfatun Nona, Murtiliana Nurani, Ayudyah Okinarum, Giyawati Yulilania Oktaviani, Fransiska Sela Pratiningrum, Dwi Lestari Prawinda, Raras Ayu Putra, Fatra Nongala Putri, Marsanda Avilia Ramila, Audiza Asssyifa Ramila, Audiza Assyifa Ratu Ilma Indra Putri Rika Mellyaning Khoiriya Rini, Sulistio Risdiana Chandra Dhewy, Risdiana Chandra Rizqita, Ayomi Rosidah, Hidayatul Sapariyah, Sapariyah Selamat Budijitno Setianingtyas, Hetty Eka Setyo Mahanani Nugroho Shofa Chasani Sri Rahyuni Sri Suryanti Sudiyatmi, Sudiyatmi Suharyo Hadisaputro Sulaksono, Anang Catur Sulistyaningsih Sulistyaningsih SURAYANAH . Syarifudin, Aris Tholibin, Muhamad Sirojut Tri Nur Kristina Tricahyo, Vion Age Ulfa Niswatul W. Utami, J. Nugrahaningtyas Wagimun, Wagimun Wahyu Hidayati wahyuni, kenik sri Winurdana8, Alfan Setya Yohannes Kurniawan Barus Yuliani, Istri Zainuddin, M Zainudin, M Zainudin, Mohammad