Plasma exchange for paediatric kidney disease--indications and outcomes: a single-centre experience

Background Outcome data in paediatrics regarding the use of plasmapheresis for immunological kidney disease are scarce. Objectives We aimed to evaluate the role of plasmapheresis in children presenting with severe renal impairment secondary to immunological kidney diseases. Methods A retrospective chart review of children admitted between January 2009 and August 2013 to the Paediatric Nephrology Unit, Christian Medical College, Vellore, India, and requiring plasma exchange was undertaken. Demographic and clinical data were studied and descriptive statistics applied for analysis. Results Sixteen children underwent plasmapheresis with a male:female ratio of 10:6 and a mean age of 10.2 years (range 5–15 years). Twelve children had atypical haemolytic uraemic syndrome, two had anti-glomerular basement disease and one each had lupus nephritis with neurological manifestation and anti-nuclear cytoplasmic antibody–associated vasculitis. The mean serum creatinine at presentation was 6.52 [interquartile range (IQR) 4.96–7.85] mg/dL with a mean eGFR of 43 (IQR 27.54–56.7) mL/min/1.73 m2. Other presenting features included nephrotic range proteinuria (69%), gross haematuria (27%), hypertension (94%) and seizures (37.5%). All children received 1.5 times plasma volume plasmapheresis (mean 11 sessions, range 5–26), dialysis and immunosuppressive therapy. The mean duration of follow-up was 4 months (range 2–24 months) with a majority of the children (15...
Source: CKJ: Clinical Kidney Journal - Category: Urology & Nephrology Authors: Tags: THROMBOTIC MICROANGIOPATHY Source Type: research