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However, whether plasma exchange, in addition to pulse glucocorticoid therapy, would benefit patients with anti-GBM disease with dialysis-dependent kidney failure without diffuse alveolar hemorrhage remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the Japanese Diagnosis Procedure Combination database, we identified patients diagnosed with anti-GBM disease with dialysis-dependent kidney failure\u00a0and\u00a0without diffuse alveolar hemorrhage from July 2010 to March 2020. We compared in-hospital mortality within 10\u00a0days of hospitalization between patients who received therapeutic plasma exchange in addition to pulse glucocorticoid therapy and those who received pulse glucocorticoid therapy alone. Overlap weighting based on propensity score was performed to adjust for potential confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 207 eligible patients; 168 patients received therapeutic plasma exchange plus pulse glucocorticoid therapy, while 39 patients received pulse glucocorticoid therapy alone. The mean dose of therapeutic plasma exchange was 52.2\u00a0ml\/kg\/day of albumin and\/or fresh frozen plasma. Therapeutic plasma exchange in addition to pulse glucocorticoid therapy was associated with a lower in-hospital mortality risk in the unweighted (10.7% versus 28.2%; risk difference, 17.5%; 95% confidence interval, 2.6\u201332.4%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.02) and weighted analyses (11.5% versus 28.4%; risk difference, 17.0%; 95% confidence interval, 1.5\u201332.5%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.03) than pulse glucocorticoid therapy alone.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This retrospective cohort study using a national database suggests that therapeutic plasma exchange may improve the in-hospital prognosis of anti-GBM disease with dialysis-dependent kidney failure and without diffuse alveolar hemorrhage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s40620-023-01695-9","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T08:47:04Z","timestamp":1687596424000},"page":"2317-2325","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Therapeutic plasma exchange for anti-glomerular basement membrane disease with dialysis-dependent kidney failure without diffuse alveolar hemorrhage"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3925-2665","authenticated-orcid":false,"given":"Hideaki","family":"Watanabe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hayato","family":"Yamana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Okada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Matsui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyohide","family":"Fushimi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideo","family":"Yasunaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,6,24]]},"reference":[{"key":"1695_CR1","doi-asserted-by":"publisher","first-page":"1162","DOI":"10.2215\/CJN.01380217","volume":"12","author":"SP McAdoo","year":"2017","unstructured":"McAdoo SP, Pusey CD (2017) Anti-glomerular basement membrane disease. 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Watanabe reports officer role for Watanabe Oyster Laboratory Co., Ltd. A. Okada is a member of the Department of Prevention of Diabetes and Lifestyle-Related Diseases, which is a cooperative program between The University of Tokyo and the Asahi Mutual Life Insurance Company. H. Yamana is a member of the Department of Health Services Research, which is a cooperative program between The University of Tokyo and Tsumura & Co. H. Matsui, K. Fushimi, and H. Yasunaga have nothing to declare regarding potential conflicts of interest relevant to this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the Institutional Review Board of the Graduate School of Medicine, the University of Tokyo, approval number 3501-(5). Owing to the anonymous character of the data, the requirement for informed consent was waived. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}