Plasmapheresis for the treatment of kidney diseases

Clark, William F.; Huang, Shih‐Han S.; Walsh, Michael; Farah, Myriam; Hildebrand, Ainslie M.; Sontrop, Jessica M.

doi:10.1016/j.kint.2016.06.009

Cited by 48 publications

(30 citation statements)

References 127 publications

(179 reference statements)

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“…Therapy should address the underlying cause of CV, and consists mainly of antiviral drugs for HCV, immunosuppressive agents for lymphoproliferative disorders and autoimmune diseases. TPE has been employed since the 1980s as adjunctive therapy in organ or life‐threatening CV manifestations, such as glomerulonephritis, severe refractory cutaneous vasculitis and hyperviscosity syndrome (Berkman & Orlin, ; Evans et al , ; Clark et al , ). The largest multicentre cohort study reported a significant beneficial effect in almost 50% of cases, while improvement of baseline condition was partial in 25% and insufficient in 22% of cases (Marson et al , ).…”

Section: Tpe In Non‐haematological Autoimmune Disordersmentioning

confidence: 99%

The role of plasma exchange in the management of autoimmune disorders

Zanatta

Cozzi²,

Marson

et al. 2019

Br J Haematol

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Summary Therapeutic plasma exchange (TPE) has been mainly used in the treatment of autoimmune diseases. The main mechanisms of action of TPE include the removal of circulating autoantibodies, immune complexes, complement components, cytokines and adhesion molecules, along with sensitization of antibody‐producing cells to immunosuppressant agents. TPE is useful in autoimmune haematological, renal, rheumatic and neurological diseases, and is recommended for acute disorders, together with relapsed or worsened chronic diseases that are often unresponsive to conventional treatments. The American Society for Apheresis and the British Society of Haematology have published guidelines on the clinical use of apheresis procedures, indicating the different levels of efficacy of TPE. Based on the evidence from current literature and our personal experience, this review discusses the indications and the suggested regimens for TPE in autoimmune haematological and non‐haematological disorders.

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Section: Tpe In Non‐haematological Autoimmune Disordersmentioning

confidence: 99%

The role of plasma exchange in the management of autoimmune disorders

Zanatta

Cozzi²,

Marson

et al. 2019

Br J Haematol

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“…The kidneys are the target organ in a wide variety of autoimmune diseases, particularly such as systemic lupus erythematosus (lupus nephritis), Goodpasture's syndrome, purpura Henoch-Schönlein, Wegener's granulomatosis, polyarteritis nodosa, in which vasculitis is an important component of the pathogenesis. And application of a plasma exchange is here too justified [24,25].…”

Section: Kidney Damage In Vasculitismentioning

confidence: 99%

Perspectives of Plasmapheresis in the Treatment of Kidney Diseases

Voinov¹

2018

IJCU

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Many kidney diseases pose a serious threat to human health and even life. In some cases, they inevitably lead to hemodialysis and even the need for kidney transplantation. Almost all chronic kidney disease in varying degrees, are associated with disorders of the internal environment, mainly autoimmune nature. Drug therapy is not always effective and can lead to additional disorders. Pathogenetically justified is the use of plasmapheresis. The aim of this study was to analyze the modern world literature in order to identify the features of the pathogenesis and course of various forms of chronic kidney disease in terms of determining the possibility of using plasmapheresis and indications for it. With the help of plasmapheresis, a number of problems can be solved in urology, in particular in the treatment of pyelonephritis, prostatitis and even male infertility.

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“…Historically, plasmapheresis was first applied to humans in 1952 to treat hyperviscosity in multiple myeloma [1]. The first plasmapheresis in kidney diseases was attempted by Bukowski et al [2]; they successfully treated two patients with thrombotic thrombocytopenic purpura (TTP) and renal impairment in 1977.…”

Section: Introductionmentioning

confidence: 99%

Clinical analysis of single filtration plasmapheresis using continuous renal replacement therapy machines in kidney transplantation

Lim

Kim

Jeong

et al. 2017

Kidney Res Clin Pract.

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BackgroundPlasmapheresis has become an essential element of kidney transplantation (KT). In the present study, we report clinical outcomes of filtration plasmapheresis using continuous renal replacement therapy machines with a single filter for the first time in Korea.MethodsWe retrospectively analyzed six patients who underwent filtration plasmapheresis for KT in our center; plasmapheresis was performed using the Plasmaflex (Baxter®) with a TPE 2000 filter set (Baxter®) in our hemodialysis unit. Five percent albumin was used as the replacement fluid, and intravenous immunoglobulin G was administered after each plasmapheresis session. The target preoperative ABO isoagglutinin titer was less than 1:8.ResultsFiltration plasmapheresis was performed in four patients for ABO-incompatible KT, one for antibody-mediated rejection after KT, and the last one for positive T cell crossmatch. Altogether, 46 sessions of plasmapheresis were performed. ABO isoagglutinin titers successfully declined to or below the target level in all patients, and all patients successfully received KT with no significant antibody titer rebound. Acute antibody-mediated rejection and positive T cell crossmatch were well treated with filtration plasmapheresis, and no patient required fresh frozen plasma infusion for coagulopathy. There were one episode of hypotension and three of hypocalcemia. No patients experienced bleeding, infection, or allergic reaction.ConclusionFiltration plasmapheresis was effective and safe. Although our result is from a single center, our protocol appears to be promising.

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Plasmapheresis for the treatment of kidney diseases

Cited by 48 publications

References 127 publications

The role of plasma exchange in the management of autoimmune disorders

The role of plasma exchange in the management of autoimmune disorders

Perspectives of Plasmapheresis in the Treatment of Kidney Diseases

Clinical analysis of single filtration plasmapheresis using continuous renal replacement therapy machines in kidney transplantation

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