Guidelines on the Use of Therapeutic Apheresis in Clinical Practice – Evidence‐Based Approach from the Writing Committee of the American Society for Apheresis: The Eighth Special Issue

Journal of Clinical Apheresis, Год журнала: 2019, Номер 34(3), С. 171 - 354

Опубликована: Июнь 1, 2019

ABSTRACT The American Society for Apheresis (ASFA) Journal of Clinical (JCA) Special Issue Writing Committee is charged with reviewing, updating and categorizing indications the evidence‐based use therapeutic apheresis (TA) in human disease. Since 2007 JCA (Fourth Edition), committee has incorporated systematic review approaches grading categorization indications. This Eighth Edition continues to maintain this methodology rigor order make recommendations on a wide variety diseases/conditions. Edition, like its predecessor, apply category system definitions fact sheets. general layout concept sheet that was introduced Fourth largely been maintained edition. Each succinctly summarizes evidence TA specific disease entity or medical condition. comprises 84 sheets relevant diseases conditions, 157 graded categorized and/or modalities. seeks continue serve as key resource guides utilization treatment

Язык: Английский

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Guidelines on the Use of Therapeutic Apheresis in Clinical Practice – Evidence‐Based Approach from the Writing Committee of the American Society for Apheresis: The Ninth Special Issue

Journal of Clinical Apheresis, Год журнала: 2023, Номер 38(2), С. 77 - 278

Опубликована: Апрель 1, 2023

The American Society for Apheresis (ASFA) Journal of Clinical (JCA) Special Issue Writing Committee is charged with reviewing, updating, and categorizing indications the evidence-based use therapeutic apheresis (TA) in human disease. In Ninth Edition, JCA has incorporated systematic review approaches grading evidence categorization to make recommendations on a wide variety diseases conditions. This edition largely maintained general layout concept fact sheet introduced Fourth Edition (2007). Each succinctly summarizes TA specific disease or medical condition. comprises 91 sheets 166 graded categorized indications. includes seven new sheets, nine existing eight changes category seeks continue serve as key resource that guides utilization treatment

Язык: Английский

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IPNA clinical practice recommendations for the diagnosis and management of children with steroid-resistant nephrotic syndrome

Pediatric Nephrology, Год журнала: 2020, Номер 35(8), С. 1529 - 1561

Опубликована: Май 7, 2020

Abstract Idiopathic nephrotic syndrome newly affects 1–3 per 100,000 children year. Approximately 85% of cases show complete remission proteinuria following glucocorticoid treatment. Patients who do not achieve within 4–6 weeks treatment have steroid-resistant (SRNS). In 10–30% patients, mutations in podocyte-associated genes can be detected, whereas an undefined circulating factor immune origin is assumed the remaining ones. Diagnosis and management SRNS a great challenge due to its heterogeneous etiology, frequent lack by further immunosuppressive treatment, severe complications including development end-stage kidney disease recurrence after renal transplantation. A team experts pediatric nephrologists geneticists from International Pediatric Nephrology Association (IPNA), pathologist, adult nephrologist now developed comprehensive clinical practice recommendations on diagnosis children. The performed systematic literature review 9 clinically relevant PICO ( P atient or opulation covered, I ntervention, C omparator, O utcome) questions, formulated formally graded them at consensus meeting, with input patient representatives dietician acting as external advisors voting panel nephrologists. Research are also given.

Язык: Английский

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Recent advances in nanotechnology-based drug delivery systems for the kidney

Journal of Controlled Release, Год журнала: 2020, Номер 321, С. 442 - 462

Опубликована: Фев. 14, 2020

Язык: Английский

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Lipid Toxicity in the Cardiovascular-Kidney-Metabolic Syndrome (CKMS)

Biomedicines, Год журнала: 2024, Номер 12(5), С. 978 - 978

Опубликована: Апрель 29, 2024

Recent studies of Cardiovascular-Kidney-Metabolic Syndrome (CKMS) indicate that elevated concentrations derivatives phospholipids (ceramide, sphingosine), oxidized LDL, and lipoproteins (a, b) are toxic to kidney heart function. Energy production for renal proximal tubule resorption critical fuels electrolytes is required homeostasis. Cardiac energy ventricular contraction/relaxation preferentially supplied by long chain fatty acids. Metabolism acids accomplished within the cardiomyocyte cytoplasm mitochondria means glycolytic, tricarboxylic acid, electron transport cycles. Toxic lipids excessive lipid may inhibit cardiac contraction requires calcium movement from sarcoplasmic reticulum a high low concentration at relatively cost. relaxation involves return lower higher more consumption. Diastolic dysfunction occurs when conversion inadequate. diminished ATP availability in presence inadequate blood pressure, glycemia, or control lead failure. Similar disruption tubular fuels/electrolytes has been found be associated with phospholipid (sphingolipid) accumulation. Elevated tissue low-density lipoprotein cholesterols loss filtration efficiency level glomerular podocyte. Macroscopically deposits epicardial intra-nephric adipose vascular pathology, fibrosis, inhibition essential functions both kidney. Chronic triglyceride accumulation fibrosis liver, structures. Successful kidney, allograft these vital organs does not eliminate risk toxicity. Lipid lowering therapy assist protecting organ function before after transplantation.

Язык: Английский

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LDL-apheresis-induced remission of focal segmental glomerulosclerosis recurrence in pediatric renal transplant recipients

Pediatric Nephrology, Год журнала: 2019, Номер 34(11), С. 2343 - 2350

Опубликована: Июнь 27, 2019

Язык: Английский

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Therapeutic Plasmapheresis: a revision of literature.

Kidney & Blood Pressure Research, Год журнала: 2022, Номер 48(1), С. 66 - 78

Опубликована: Дек. 8, 2022

<b><i>Background:</i></b> Therapeutic plasmapheresis (TP) is an extracorporeal therapy that allows the removal of pathogens from plasma. The role TP in immuno-mediated diseases and toxic conditions has been interest for decades. <b><i>Summary:</i></b> We reviewed recent literature on application optimal choice technique ranging plasma exchange, double filtration plasmapheresis, rheopheresis, immunoadsorptions, adsorption perfusion lipidoapheresis. In addition, we report our experience various different medical specialties, following American Society Apheresis (ASFA) recommendations. <b><i>Key Messages:</i></b> Overall patients receiving showed improvement clinical laboratory parameters. Our review single-center suggest a benefit multiple disciplines.

Язык: Английский

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The role of the immune system in idiopathic nephrotic syndrome

Molecular and Cellular Pediatrics, Год журнала: 2021, Номер 8(1)

Опубликована: Ноя. 18, 2021

Abstract Idiopathic nephrotic syndrome (INS) in children is characterized by massive proteinuria and hypoalbuminemia usually responds well to steroids. However, relapses are frequent, which can require multi-drug therapy with deleterious long-term side effects. In the last decades, different hypotheses on molecular mechanisms underlying INS have been proposed several lines of evidences strongly indicate a crucial role immune system pathogenesis non-genetic INS. traditionally considered T-cell-mediated disorder triggered circulating factor, causes impairment glomerular filtration barrier subsequent proteinuria. Additionally, imbalance between Th17/Tregs as Th2/Th1 has implicated pathomechanism Interestingly, B-cells gained attention, since rituximab, an anti-CD20 antibody demonstrated good therapeutic response treatment Finally, recent findings that even podocytes act antigen-presenting cells under inflammatory stimuli play direct activating cellular pathways cause Even though our knowledge still incomplete, it became clear instead cell subset or one particular molecule causative factor for INS, multi-step control including soluble factors, cells, necessary prevent occurrence This present review aims provide overview current this topic, advances understanding immunopathogenesis may help drive new tailored approaches forward.

Язык: Английский

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Focal segmental glomerulosclerosis: Risk for recurrence and interventions to optimize outcomes following recurrence

Pediatric Transplantation, Год журнала: 2022, Номер 26(6)

Опубликована: Май 19, 2022

Abstract Background FSGS is a common indication for kidney transplant with high‐risk of posttransplant recurrence. Methods In this review, we summarize current knowledge about recurrence after transplantation, including epidemiology, pretransplant planning, management, and investigational treatments. Results recurs in 14%–60% first transplants, likely associated circulating permeability factor. Pretransplant counseling regarding critical, patients should undergo genetic screening. Rapid progression to ESKD, initial steroid responsiveness, younger age at diagnosis, race/ethnicity, mesangial hypercellularity or minimal change histology on native biopsy may be Living donation not contraindicated but does result improved graft survival relative deceased donation. nephrectomy performed variety reasons, decrease therapy rituximab and/or PE understudied clearly effective preventing Patients typically present early rapid‐onset severe proteinuria. Diagnosis can confirmed by showing foot process effacement; typical lesions are seen light microscopy the stages. There no established treatment recurrent FSGS, renin–angiotensin–aldosterone system inhibition extracorporeal therapies, IA, most commonly used. Adjunct alternative therapies include rituximab, lipopheresis, cyclosporine.

Язык: Английский

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Therapeutic apheresis in kidney diseases: an updated review

Renal Failure, Год журнала: 2022, Номер 44(1), С. 842 - 857

Опубликована: Июнь 19, 2022

Besides conventional medical therapies, therapeutic apheresis has become an important adjunctive or alternative option to immunosuppressive agents for primary secondary kidney diseases and transplantation. The available techniques used in diseases, including plasma exchange, double-filtration plasmapheresis, immunoadsorption, low-density lipoprotein apheresis. Plasma exchange is still the leading extracorporeal therapy. Recently, growing evidence supports potential benefits of plasmapheresis immunoadsorption more specific effective clearance pathogenic antibodies with fewer side effects. However, randomized controlled trials are needed. Low-density also supplementary therapy patients recurrent focal segmental glomerulosclerosis. This review collects latest from recent studies, focuses on advantages disadvantages these techniques, compares discrepancy among them determine optimal regimens certain diseases.

Язык: Английский

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