Sułowicz Władysław, Stompór Tomasz
Chair and Department of Nephrology, Jagiellonian University, Cracow, Poland.
Nephrol Dial Transplant. 2003 Jul;18 Suppl 5:v59-62. doi: 10.1093/ndt/gfg1050.
Plasma exchange was used for many years as the method of extracorporeal removal of antibodies and/or immune complexes that may be involved in the pathogenesis of renal diseases. Recently low-density lipoprotein (LDL)-apheresis and immunoadsorption were also introduced into nephrological practice. LDL-apheresis, designed originally as a rescue treatment for refractory hyperlipidaemia, appeared also to be effective in certain glomerulopathies, resistant to other treatment strategies. Similarly, immunoadsorption can be employed successfully in the treatment of different nephropathies, of both immunological and non-immunological pathogenesis. This method may also be effective as rescue treatment in some cases of acute rejection and recurrence of certain nephropathies after renal transplantation. The major advantage of both methods is their increased selectivity compared with standard plasma exchange. In addition, these techniques need no supplement fluid (namely fresh frozen plasma), which allows for markedly increased efficacy of the treatment as well as substantial reduction of infection risks.
血浆置换多年来一直被用作体外清除可能参与肾脏疾病发病机制的抗体和/或免疫复合物的方法。最近，低密度脂蛋白（LDL）吸附和免疫吸附也被引入肾脏疾病的治疗实践中。LDL吸附最初设计用于难治性高脂血症的抢救治疗，在某些对其他治疗策略耐药的肾小球疾病中似乎也有效。同样，免疫吸附可成功用于治疗不同发病机制的免疫性和非免疫性肾病。该方法在肾移植后急性排斥反应和某些肾病复发的一些病例中作为抢救治疗也可能有效。这两种方法的主要优点是与标准血浆置换相比，它们的选择性更高。此外，这些技术不需要补充液（即新鲜冷冻血浆），这使得治疗效果显著提高，同时感染风险大幅降低。
