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Therapy consists of a combination of Rituximab, corticosteroids, and cyclophosphamide, with a substitution of azathioprine for cyclophosphamide after a ninety-day initial period being another option. Rituximab has been shown to be better than cyclophosphamide at treating continuous relapse in disease. Plasmapheresis can be used for patients who present with severe kidney failure. Plasmapheresis has been shown to ineffective in long term treatment of AAV. When remission is achieved, immunosuppressants are still used, usually corticosteroids with azathioprine or rituximab infusions. The predictor of kidney survival is serum creatinine value.