| Summary: | Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis presenting with severe
acute kidney injury (AKI), consistent with rapidly progressive glomerulonephritis portends
significant renal morbidity with up to 20%–25% of patients reaching end stage renal disease
within a few years after diagnosis. Nevertheless, a smaller proportion of patients require
dialysis at presentation or within the first six months. There is still some debate as to the first
line therapy of choice for such patients vis a vis the use of the newer agent rituximab versus the
time-tested cyclophosphamide in combination with glucocorticoids. Our recent experience at
The Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA in
June 2018 allowed us to revisit this controversy.
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