Aggressive treatment can usually save the kidneys if caught in time. And often, usually, most symptoms improve with right treatment. For most of us things are usually at their worst at the time symptoms get bad enough to result in the correct diagnosis. GPA (formerly known as Wegener's Granulomatosis) is usually diagnosed by ruling out any other possible cause of the symptoms. Be sure to include good eye care since GPA can cause loss of vision too and many other things. Much of the damage can be permanent so getting quick treatment is needed to avoid this. But treatment today is generally much better since more doctors have become aware of GPA and how to treat it but management is best done with some one with considerable experience treating it.