Nomenclature of Extracorporeal Blood Purification Therapies for Acute Indications: The Nomenclature Standardization Conference

Blood Purification, Год журнала: 2023, Номер 53(5), С. 358 - 372

Опубликована: Ноя. 3, 2023

The development of new extracorporeal blood purification (EBP) techniques has led to increased application in clinical practice but also inconsistencies nomenclature and misunderstanding. In November 2022, an international consensus conference was held establish on the terminology EBP therapies. It agreed define therapies as that use circuit remove and/or modulate circulating substances achieve physiological homeostasis, including support function specific organs detoxification. Specific acute include renal replacement therapy, isolated ultrafiltration, hemoadsorption, plasma therapies, all which can be applied isolation combination. This paper summarizes proposed serves a framework for future research.

Язык: Английский

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Efficacy of extracorporeal plasma therapy for adult native kidney patients with Primary FSGS: a Systematic review

Renal Failure, Год журнала: 2023, Номер 45(1)

Опубликована: Фев. 10, 2023

Purpose This study aimed to assess efficacy of extracorporeal plasma therapy (EPT), including plasmapheresis (PE), immunoadsorption (IA), low-density lipoprotein apheresis (LDL-A), and lymphocytapheresis (LCAP) for adult native kidney patients with primary focal segmental glomerulosclerosis (FSGS).Methods A literature search was conducted using MEDLINE, EMBASE Cochrane Databases through August 2022. Studies that reported outcomes EPT in kidneys FSGS were enrolled.Results 18 studies 104 therapy-resistant or refractory identified. Overall response rate 56%, long-term benefit 46%. Of the 101 non-hemodialysis (HD) patients, 54% achieved remission, 30% complete remission (CR) 23% partial (PR). 31 PE, 65%; CR PR rates 27% 37% 30 non-HD patients. 61 LDL-A, 54%; 41% 3% 29 10 IA, 40%. 2 LCAP, 1 CR, one developed renal failure. All 3 HD showed increase urine output gradual decrease protein excretion following PE (n = 1) LDL-A 2). ultimately discontinued dialysis.Conclusion immunosuppressive some FSGS, appeared have a higher rate.

Язык: Английский

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Incidence and risk factors for recurrent focal segmental glomerulosclerosis after kidney transplantation: a meta-analysis

Renal Failure, Год журнала: 2023, Номер 45(1)

Опубликована: Апрель 18, 2023

To systematically review the incidence and risk factors for recurrent FSGS after kidney transplantation.We searched PubMed, Embase, Medline, Web of Science, Cochrane Library, CNKI, CBMdisc, Wanfang, Weipu case-control studies related to from establishment until October 2022. The protocol was registered on PROSPERO (CRD42022315448). Data were analyzed using Stata 12.0, with odds ratios (counting data) standardized mean difference (continuous being considered as effect sizes. If I2 value greater than 50%, random-effects model used; otherwise, a fixed-effects used. A meta-analysis transplantation performed.A total 22 966 patients 12 included in meta-analysis. There 358 608 without transplantation. results showed that recurrence rate 38% (95% CI: 31%-44%). Age at (SMD = -0.47, 95% CI -0.73 -0.20, p .001), age onset -0.31, -0.54 -0.08, .008), time diagnosis failure -0.24, -0.43 -0.04, .018), proteinuria before KT 2.04, 0.91 - 3.17, < donor (OR 1.99, 1.20 3.30, .007) nephrectomy native kidneys 6.53, 2.68 15.92, .001) associated FSGS, whereas HLA mismatches, duration dialysis KT, sex, living donor, tacrolimus use previous not transplantation.The remains high. Clinical decision-making should warrant further consideration these factors, including age, original disease progression, proteinuria, kidneys.

Язык: Английский

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Complex Clinical Interplay: A Case Report of Systemic Lupus Erythematosus Coexisting With Type II Cryoglobulinemia

Cureus, Год журнала: 2025, Номер unknown

Опубликована: Янв. 5, 2025

Systemic lupus erythematosus (SLE) is a multi-faceted autoimmune disease with diverse clinical manifestations, often diagnosed through specific immunological markers. Another noteworthy phenomenon associated SLE cryoglobulinemia (CG), characterized by circulating immunoglobulins that precipitate at lower temperatures. Although the overlap of and CG documented, its precise prevalence remains elusive. This paper presents unique case patient cryoglobulinemic glomerulonephritis biopsy. The attained full remission after an initial induction using Eurolupus protocol complemented plasmapheresis, subsequent maintenance therapy managed via rituximab.

Язык: Английский

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Therapeutic Plasma Exchange: Analysis of Practices and Compliance With International Guidelines

Journal of Clinical Apheresis, Год журнала: 2025, Номер 40(2)

Опубликована: Апрель 1, 2025

ABSTRACT Therapeutic plasma exchange (TPE) is widely used in the treatment of autoimmune diseases and hematological emergencies. It also applied transplant patients for desensitization anti‐HLA (human leukocyte antigen) antibodies management antibody‐mediated rejection. This study aims to assess epidemiology therapeutic plasmapheresis evaluate whether indications align with guidelines American Society Apheresis (ASFA) investigate associated adverse effects. retrospective observational was conducted hospitals Belo Horizonte, Minas Gerais, included 85 who underwent 493 TPE sessions between April 2021 December 2023. The median age 43 years, 60% were women. most common neuromyelitis optica (24%) acute rejection following kidney transplantation (21%). replacement fluids primarily albumin (84%) frozen 24 h after phlebotomy (16%). Adverse events reported 5.88% patients, including hypotension, vasovagal reflex, one case facial edema urticaria. No procedure‐related deaths observed. accordance ASFA, 50% procedures classified as Category I. There no significant association patient diagnoses. demonstrated that effective safe, predominant rejection, ASFA guidelines. rare manageable.

Язык: Английский

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Efficacy and molecular mechanisms of natural polysaccharides in the treatment of kidney diseases

Journal of Functional Foods, Год журнала: 2025, Номер 129, С. 106859 - 106859

Опубликована: Май 1, 2025

Язык: Английский

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Double filtration plasmapheresis combined with rituximab for donor‐specific antibody desensitization in haploidentical haematopoietic stem cell transplantation

British Journal of Haematology, Год журнала: 2023, Номер 203(5), С. 829 - 839

Опубликована: Авг. 24, 2023

Donor-specific anti-HLA antibodies (DSA) are a major cause of engraftment failure in patients receiving haploidentical haematopoietic stem cell transplantation (Haplo-HSCT). Double filtration plasmapheresis (DFPP) avoids the unnecessary loss plasma proteins and increases efficiency purification. To investigate effectiveness desensitization protocol including DFPP rituximab, we conducted nested case-control study. Thirty-three who had positive DSA were desensitized by 99 with negative randomly matched as control. The median mean fluorescence intensity values before after treatment 7505.88 ± 4424.38 versus 2013.29 4067.22 (p < 0.001). All group achieved reconstitution neutrophils platelets times 13 (10-21) (10-29) days respectively. Although cumulative incidence II-IV aGVHD (41.4% vs. 28.1%) 3-year moderate to severe cGVHD (16.8% 7.2%) higher cohort than control, no statistical significance was observed. non-relapse mortality overall survival 6.39% 72.0%, respectively, cohort, which comparable In conclusion, rituximab could be effectively used for overcome effects Haplo-HSCT.

Язык: Английский

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The effects of double-filtration plasmapheresis on coagulation profiles and the risk of bleeding

Journal of the Formosan Medical Association, Год журнала: 2024, Номер 123(8), С. 899 - 903

Опубликована: Фев. 23, 2024

Double-filtration plasmapheresis (DFPP) can be used to remove circulating pathogenic molecules. By reclaiming filtered albumin, DFPP reduces the need for albumin and plasma replacement. Large proteins, such as fibrinogen, are removed. Our institution adopts a treatment protocol consisting of active surveillance coagulation profiles prophylactic supplementation blood products containing fibrinogen. This study aims investigate effects consecutive treatments on serial risk bleeding under this protocol. Serial laboratory data events at single tertiary medical center were prospectively collected. Prophylactic transfusion cryoprecipitate or fresh frozen (FFP) was instituted if significant coagulopathy clinically evident event observed. After first session, fibrinogen levels decreased from 332 ± 106 mg/dL 96 44 in 37 patients. In following sessions, maintained around 100 transfusion. No major recorded, but five (14%) patients experienced minor bleeding. might performed safely along with monitoring FFP.

Язык: Английский

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Novel approaches to primary membranous nephropathy: Beyond the KDIGO guidelines

European Journal of Pharmacology, Год журнала: 2024, Номер 982, С. 176928 - 176928

Опубликована: Авг. 23, 2024

Язык: Английский

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Heparin anticoagulation versus regional citrate anticoagulation for membrane therapeutic plasma exchange in patients with increased bleeding risk

Renal Failure, Год журнала: 2023, Номер 45(1)

Опубликована: Май 15, 2023

Background Heparin anticoagulation (HA) is commonly employed for membrane therapeutic plasma exchange (mTPE). However, patients with increased bleeding risk, there were controversial opinions on the use of HA versus regional citrate (RCA) mTPE. Our present study aimed to evaluate efficacy and safety vs. RCA mTPE in risk.Methods Patients risk who underwent between 2014 2021 our center screened. Observations used as endpoints.Results A total 108 368 sessions included. Of included patients, 38 70 received mTPE, respectively. There was no significant difference clotting extracorporeal circuits groups (4.1% 4.4%, p = 0.605). More episodes observed group compared (16.4% 4.4% sessions, < 0.001). The frequency postoperative transfusion within 24 h (11% 3.4%, 0.007) significantly different group. Anticoagulation strategy (HA RCA; OR 5.659, 95%CI 2.266-14.129; 0.001), mean arterial pressure (prior treatment, 1.052, 1.019-1.086; 0.002) independent factors episodes. At end incidence metabolic alkalosis (16.7% 54.1%, 0.027) hypocalcemia (41.7% 89.2%, 0.001) (n 5, 12 sessions) 22, 74 groups, respectively.Conclusion effective associated a lower bleeding, HA. With careful monitoring timely adjustment, most likely safe option risk.

Язык: Английский

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