Nicholls K, Becker G, Walker R, Wright C, Kincaid-Smith P
Department of Nephrology, Royal Melbourne Hospital, Parkville, Australia.
J Clin Apher. 1990;5(3):128-32. doi: 10.1002/jca.2920050303.
A therapeutic trial of plasma exchange was performed in 13 patients with documented progressive IgA nephropathy. Comparison of the rate of deterioration in renal function before, during, and after plasma exchange demonstrated significant improvement during plasma exchange. Seven patients had a slowed rate of deterioration by plasma exchange, but achieved a decrease in serum creatinine level. Favourable response was correlated with rapidity of deterioration preplasma exchange (P less than 0.01) and was apparent within 4 weeks of commencing therapy in those patients who responded. There was no overall difference between the deterioration rates pre- and postplasma exchange. In patients in whom creatinine decreased on plasma exchange, the initiation of subsequent dialysis was delayed.
对13例确诊为进行性IgA肾病的患者进行了血浆置换治疗试验。比较血浆置换前、期间及之后的肾功能恶化速率，结果显示在血浆置换期间肾功能有显著改善。7例患者经血浆置换后肾功能恶化速率减缓，血清肌酐水平下降。良好反应与血浆置换前恶化的快速程度相关（P<0.01），且在开始治疗后4周内，有反应的患者即表现出明显效果。血浆置换前后的恶化速率总体无差异。接受血浆置换后肌酐下降的患者，后续透析的启动时间延迟。
