Current indication of plasma exchanges in nephrology: A systematic review
Therapeutic plasma exchange (TPE) has been firstly performed with centrifugation devices used in blood banking procedures. Nowadays, TPE is increasingly performed in intensive care units using hemodiafiltration generators that ensure better efficiency and simplicity. However, prescription for the di...
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Wolters Kluwer Medknow Publications
2011-01-01
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doaj-5d3000725da241d2ad54439b91a7f59c2020-11-24T22:31:00ZengWolters Kluwer Medknow PublicationsSaudi Journal of Kidney Diseases and Transplantation1319-24422011-01-01222219224Current indication of plasma exchanges in nephrology: A systematic reviewSidy M SeckDussol BertrandDiouf BoucarTherapeutic plasma exchange (TPE) has been firstly performed with centrifugation devices used in blood banking procedures. Nowadays, TPE is increasingly performed in intensive care units using hemodiafiltration generators that ensure better efficiency and simplicity. However, prescription for the different medical pathologies depends on weak evidence-based recommen-dations, and is often guided by the clinician′s own experience. In this review, we briefly recall the rationale of TPE prescription before discussing the evidence level of common indications of TPE in nephrology. Currently, strong evidence-based data for the benefit of TPE is clearly demonstrated in renal diseases such as hemolytic uremic syndrome, anti-glomerular basement membrane vasculitis, and recurrent glomerulonephritis after kidney transplantation and management of humoral renal allograft rejection in high-risk recipients. However, the other indications of TPE, such as renal vasculitis associated with anti-neutrophil cytoplasmic antibodies, mixed cryoglobulinemia, periarte-ritis nodosa, and acute renal failure in myeloma are still controversial. Finally, TPE have been found to be clearly inefficient in lupus nephritis, except for patients with associated thrombotic mic-roangiopathy or catastrophic antiphospholipid antibodies syndrome. More randomized clinical trials are required to precisely place TPE in the management of renal diseases. Meanwhile, the decision to use this burdensome and costly therapy should be individualized according to its proven benefits and potential complications.http://www.sjkdt.org/article.asp?issn=1319-2442;year=2011;volume=22;issue=2;spage=219;epage=224;aulast=Seck |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sidy M Seck Dussol Bertrand Diouf Boucar |
spellingShingle |
Sidy M Seck Dussol Bertrand Diouf Boucar Current indication of plasma exchanges in nephrology: A systematic review Saudi Journal of Kidney Diseases and Transplantation |
author_facet |
Sidy M Seck Dussol Bertrand Diouf Boucar |
author_sort |
Sidy M Seck |
title |
Current indication of plasma exchanges in nephrology: A systematic review |
title_short |
Current indication of plasma exchanges in nephrology: A systematic review |
title_full |
Current indication of plasma exchanges in nephrology: A systematic review |
title_fullStr |
Current indication of plasma exchanges in nephrology: A systematic review |
title_full_unstemmed |
Current indication of plasma exchanges in nephrology: A systematic review |
title_sort |
current indication of plasma exchanges in nephrology: a systematic review |
publisher |
Wolters Kluwer Medknow Publications |
series |
Saudi Journal of Kidney Diseases and Transplantation |
issn |
1319-2442 |
publishDate |
2011-01-01 |
description |
Therapeutic plasma exchange (TPE) has been firstly performed with centrifugation devices used in blood banking procedures. Nowadays, TPE is increasingly performed in intensive care units using hemodiafiltration generators that ensure better efficiency and simplicity. However, prescription for the different medical pathologies depends on weak evidence-based recommen-dations, and is often guided by the clinician′s own experience. In this review, we briefly recall the rationale of TPE prescription before discussing the evidence level of common indications of TPE in nephrology. Currently, strong evidence-based data for the benefit of TPE is clearly demonstrated in renal diseases such as hemolytic uremic syndrome, anti-glomerular basement membrane vasculitis, and recurrent glomerulonephritis after kidney transplantation and management of humoral renal allograft rejection in high-risk recipients. However, the other indications of TPE, such as renal vasculitis associated with anti-neutrophil cytoplasmic antibodies, mixed cryoglobulinemia, periarte-ritis nodosa, and acute renal failure in myeloma are still controversial. Finally, TPE have been found to be clearly inefficient in lupus nephritis, except for patients with associated thrombotic mic-roangiopathy or catastrophic antiphospholipid antibodies syndrome. More randomized clinical trials are required to precisely place TPE in the management of renal diseases. Meanwhile, the decision to use this burdensome and costly therapy should be individualized according to its proven benefits and potential complications. |
url |
http://www.sjkdt.org/article.asp?issn=1319-2442;year=2011;volume=22;issue=2;spage=219;epage=224;aulast=Seck |
work_keys_str_mv |
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