Child Kidney Dis.  2017 Oct;21(2):81-88. 10.3339/jkspn.2017.21.2.81.

Therapeutic Plasma Exchange in Pediatric Kidney Disease: 23-year Experience at the Severance Children's Hospital in Korea

• Her SM
• Lee KH
• Kim JH
• Lee JS
• Kim PK
• Shin JI

• KMID: 2394444
• DOI: http://doi.org/10.3339/jkspn.2017.21.2.81

Abstract

PURPOSE
The American Society for Apheresis provides clinical guidelines for therapeutic apheresis in adults, but there are no guidelines for children. This study aimed to analyze the effect of therapeutic plasma exchange (TPE) in pediatric patients with various kidney diseases in Korea.
METHODS
We retrospectively reviewed the data of 16 children (up to 18 years of age) who were admitted to Severance Children's Hospital with refractory kidney disease. All patients received TPE between 1994 and 2016. Clinical and laboratory characteristics such as age, weight, sex, change in blood urea nitrogen (BUN), and creatinine level before and after TPE, and complications after TPE were analyzed.
RESULTS
The mean age and weight of the 16 patients at the time of TPE was 11.3±4.0 years and 34.6±17.5 kg, respectively. The BUN level was 35.4 mg/dL before TPE and significantly decreased to 21.5 mg/dL (P=0.025) at 1 week and 20.5 mg/dL (P=0.01) at 1 month after TPE. The creatinine level significantly decreased from 1.20 mg/dL before TPE to 0.90 mg/dL (P=0.02) at 1 week after TPE. Four complications (hypovolemia, anemia, hypocalcemia, and thrombocytopenia) were reported, but were not fatal.
CONCLUSION
Our findings suggest that TPE is an effective therapeutic modality in children with refractory kidney disease and can be indicated for the treatment of various kidney diseases.

Keyword

Blood urea nitrogen; Creatinine; Kidney disease; Pediatrics; Plasma exchange

MeSH Terms

Adult
Anemia
Blood Component Removal
Blood Urea Nitrogen
Child
Creatinine
Humans
Hypocalcemia
Kidney Diseases*
Kidney*
Korea*
Pediatrics
Plasma Exchange*
Plasma*
Retrospective Studies
Creatinine