Therapeutic plasma exchange in renal disorders

Ranganathan, Dwarakanathan; John, George T.

doi:10.4103/ijn.ijn_420_17

Cited by 10 publications

(4 citation statements)

References 54 publications

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“…Extracorporeal “blood purification,” mainly in the form of hemodialysis, has been a main clinical practice of many nephrologists for the past five decades [ 28 ]. Another possibly older procedure, therapeutic plasma exchange, separates, and then removes potential detrimental materials from the plasma of the patients [ 34 , 35 , 36 ]. In contrast to hemodialysis, therapeutic plasma exchange preferentially removes biologic substances of high molecular weight such as autoantibodies or alloantibodies, antigen–antibody complexes, and paraproteins.…”

Section: The Effects Of Covid-19 On the Kidneys And Treatment Strategiesmentioning

confidence: 99%

The Potential Use of Vitamin C to Prevent Kidney Injury in Patients with COVID-19

Wen

et al. 2021

Diseases

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The newly found SARS-CoV-2 has led to the pandemic of COVID-19, which has caused respiratory distress syndrome and even death worldwide. This has become a global public health crisis. Unfortunately, elders and subjects with comorbidities have high mortality rates. One main feature of COVID-19 is the cytokine storm, which can cause damage in cells and tissues including the kidneys. Here, we reviewed the current literature on renal impairments in patients with COVID-19 and analyzed the possible etiology and mechanisms. In addition, we investigated the potential use of vitamin C for the prevention of renal injury in those patients. It appears that vitamin C could be helpful to improve the outcomes of patients with COVID-19. Lastly, we discussed the possible protective effects of vitamin C on renal functions in COVID-19 patients with existing kidney conditions.

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Section: The Effects Of Covid-19 On the Kidneys And Treatment Strategiesmentioning

confidence: 99%

The Potential Use of Vitamin C to Prevent Kidney Injury in Patients with COVID-19

Wen

et al. 2021

Diseases

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“…10 Use of albumin avoids risks of plasma transfusion although effects on coagulation are more likely. 11 Thus, a combination with partial or full plasma replacement is recommended for KT by the American Society for Apheresis 1 and was planned in this case with plasma reserved for the final TPE.…”

Section: Discussionmentioning

confidence: 99%

Effect of Preoperative Therapeutic Plasma Exchange With Albumin Replacement Before Kidney Transplant on Intraoperative Coagulation Measured By the Thrombelastograph (TEGR 6s): A Case Report

Smith,

Caesar,

Perry

et al. 2023

A&A Practice

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Anesthesiologists should be aware of the coagulation implications of therapeutic plasma exchange (TPE) with albumin replacement for desensitization of kidney transplant (KT) recipients. We describe a case where the final preoperative TPE was performed with albumin. A TEGR 6s demonstrated defects in fibrinogen component to clot strength. With surgical oozing noted and the fibrinogen defect, cryoprecipitate was administered. Thereafter, fibrinogen contribution to clot strength normalized, coinciding with clinical hemostasis. With the increased use of TPE to reduce antibodies in KT recipients, visco-elastic testing may assist in the identification of coagulation defects when plasma is not used as replacement fluid.

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“…There is limited information published to date regarding plasma exchange in the context of COVID-19 vaccination. It is established that this procedure significantly depletes antibody [ 32 , 33 ]. For example, plasma exchange (replaced with albumin) may reduce immunoglobulin levels by as much as 95% [ 34 ] and would be expected to do the same for neutralizing or protective antibodies induced by vaccines targeting SARS-CoV-2.…”

Section: Sars-cov-2 Vaccines In Context Of Immunosuppression Therapymentioning

confidence: 99%

Immunosuppression in Glomerular Diseases: Implications for SARS-CoV-2 Vaccines and COVID-19

Yeaman

2021

Glomerular Dis

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Background: Glomerular diseases (GD) are chronic conditions that often involve immune dysfunction and require immunosuppressive therapy (IST) to control underlying pathogenesis. Unfortunately, such diseases appear to heighten risks of severe outcomes in COVID-19 and predispose to other infections that may be life-threatening. Thus, averting preventable infections is imperative in GD patients. Summary: The advent of vaccines demonstrated to be safe and efficacious against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has favorably impacted the COVID-19 pandemic epidemiology. However, patients on ISTs were excluded from initial vaccine clinical trials. Thus, only limited and incomplete data are available currently regarding the potential impact of immunosuppression on immune response to or efficacy of the SARS-CoV-2 vaccines. However, new insights are emerging from SARS-CoV-2 vaccine studies, and impacts of ISTs on conventional vaccines are useful to consider. Mechanisms of immunosuppressive agents commonly used in the treatment of GD are reviewed with respect to implications for immune responses induced by SARS-CoV-2 vaccines. ISTs discussed include corticosteroids; alkylating agents; antimetabolites; calcineurin or mammalian target of rapamycin inhibitors; CD38+, CD20+, or CD19+ cell depletion; and complement protein C5 inhibition. Key Messages: Many immunosuppressive therapies may potentially attenuate or impair protective immunity of the SARS-CoV-2 vaccines. However, as vaccines currently in use employ mRNA or nonreplicative viral vectors, they appear to be safe in patients on immunosuppression, further favoring vaccination. Moreover, predominant SARS-CoV-2 vaccines are likely to afford at least partial protective immunity through one or more immune mechanisms even in patients on IST. Guidelines and emerging strategies are also considered to optimize vaccine protection from COVID-19.

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Therapeutic plasma exchange in renal disorders

Cited by 10 publications

References 54 publications

The Potential Use of Vitamin C to Prevent Kidney Injury in Patients with COVID-19

The Potential Use of Vitamin C to Prevent Kidney Injury in Patients with COVID-19

Effect of Preoperative Therapeutic Plasma Exchange With Albumin Replacement Before Kidney Transplant on Intraoperative Coagulation Measured By the Thrombelastograph (TEGR 6s): A Case Report

Immunosuppression in Glomerular Diseases: Implications for SARS-CoV-2 Vaccines and COVID-19

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