Clinical outcomes of renal patients treated with therapeutic plasma exchange

Lee, Soo Youn; Kim, Nan Hee; Jeong, Sarah; Jang, Dong Seok; Lee, Young Mo; Na, Ki Ryang; Lee, Kang Wook; Shin, Young Tai

Abstract

BACKGROUND: Therapeutic plasma exchange (TPE) is a procedure by which plasma is removed from whole blood and this can be used in the treatment of some renal diseases.
METHODS
We reviewed the medical records for the chief complaints, underlying diseases, clinical courses and treatment outcomes of 23 patients who had been treated with TPE at the Renal Division of Chungnam National University Hospital from January 1995 to June 2005.
RESULTS
Patients with thrombotic thrombocytopenic purpura (TTP), microcopic polyangitis, lupus nephritis, hyperacute humoral rejection after kidney trasnplantation and rapidly progressive glomerulonephritis (RPGN) secondary to subacute bacterial endocarditis were included in this study. Among the 11 patients with TTP, six patients improved and two patients progressed to end-stage renal disease (ESRD). Three patients with TTP died. Seven patients with microscopic polyangitis and two patients with lupus nephritis had pulmonary hemorrhage at the time of TPE. Eight of the 11 TTP patients showed improvement of their pulmonary hemorrhage after TPE. One of the two patients with hyperacute humoral rejection after kidney transplantation and one patient with secondary RPGN were improved after TPE. Hypotension (three cases) was the most common adverse effect of TPE, followed by two cases of itching sensation and one case of fever with chills.
CONCLUSIONS
Therapeutic plasma exchange was an effective treatment for patients with TTP, microscopic polyangitis, lupus nephritis with pulmonary hemorrhage and hyperacute humoral rejection after kidney transplantation.