Fig. 1.

Treatment algorithm for ANCA-positive RPGN and CQs (changed from reference: the RPGN clinical practice guide 2011 by the Progressive Renal Disease Research, from the Ministry of Health, Labour and Welfare of Japan). Asterisk For older patients over 70 years, lower-grade treatment may be considered including the regimen without pulse methylprednisolone. Asterisk At the specialized hospital, higher-grade treatment may be considered under careful management irrespective of age and clinical grades. Please see other treatments (CQ 13 for Rituximab therapy, CQ 14 for Plasma exchange therapy, CQ15 for anti-coagulation and antiplatelet therapy, and CQ20 for co-trimoxazole therapy). RPGN rapidly progressive glomerulonephritis, PSL prednisolone, OCS oral corticosteroid