Renal and Patient Outcomes of Therapeutic Plasma Exchange in Nephrology Practice: A Single-Center Experience

Therapeutic plasma exchange (TPE) is an alternative treatment approach for specific conditions in the nephrology field. TPE is utilized for the treatment of ANCA-associated vasculitis, anti-GBM disease, thrombotic microangiopathy syndromes, and acute kidney transplant rejection and as part of desensitization protocols in kidney transplant recipients. However, TPE indications are limited, efficacy remains a topic of debate. With this regard, we aimed to evaluate our clinical outcomes of TPE experience among non-transplant kidney diseases. Data from 36 patients (age 44.19±18.66 years; 20 females) underwent TPE were evaluated retrospectively. The number of TPE sessions, diagnosis, pre- and post-procedure laboratory results, vascular access routes, complications, and treatment responses were recorded retrospectively from the electronic file system. Overall, patients underwent an average of 7.42±3.77 TPE sessions. Vascular access was a central venous catheter for all. TPE indications were vasculitis (n: 10), thrombotic microangiopathy (n: 20), glomerulonephritis unresponsive to treatment (n: 4), and anti-phospholipid syndrome (n: 2). 25 patients required hemodialysis, and the dialysis requirement was resolved in 11 patients at the end of treatment. There were no reported serious adverse events. Regarding renal outcome, 10 had normal renal function, 9 had chronic kidney disease, and 10 were on chronic dialysis. Seven people died, 5 of whom required dialysis at the time of diagnosis. It has been observed that the TPE, which is used as an initial, complementary, or salvage treatment option depending on the underlying disease, gives a positive response in terms of kidney and patient survival in patients with favourable initial renal functions.