Kaplan A A
Division of Nephrology, University of Connecticut Health Center, Farmington 06030, USA.
Ther Apher. 1999 Feb;3(1):25-30. doi: 10.1046/j.1526-0968.1999.00138.x.
Many primary renal diseases are associated with either antibody deposition within the glomerulus or an antibody associated autoimmunity, as may be seen with certain vasculitidies. Other immunoglobulins may be nephrotoxic or glomerulopathic; such may be the case with myeloma related light chains or cryoglobulins. Given the rapid removal of immunoglobulins by therapeutic plasma exchange, this modality has been considered an appealing management option in the treatment of these autoimmune related renal diseases. Although not classically considered as autoimmune diseases, thrombotic thrombocytopenic purpura and hemolytic uremic syndrome are related syndromes which often involve the kidneys. In many cases therapeutic plasma exchange has been found to be a useful treatment modality for these microangiopathic hemolytic anemias. This paper will provide a concise review of the renal indications for therapeutic plasma exchange.
许多原发性肾脏疾病与肾小球内抗体沉积或抗体相关的自身免疫有关，某些血管炎就是如此。其他免疫球蛋白可能具有肾毒性或肾小球病性；骨髓瘤相关轻链或冷球蛋白可能就是这种情况。鉴于治疗性血浆置换能快速清除免疫球蛋白，这种治疗方式被认为是治疗这些自身免疫相关肾脏疾病的一种有吸引力的管理选择。血栓性血小板减少性紫癜和溶血尿毒综合征虽然传统上不被视为自身免疫性疾病，但却是经常累及肾脏的相关综合征。在许多情况下，治疗性血浆置换已被发现是治疗这些微血管病性溶血性贫血的一种有效治疗方式。本文将对治疗性血浆置换的肾脏适应证进行简要综述。
