What kidney diseases can plasma exchange and immunoadsorption be used for?

The diseases that can be treated by plasma exchange or immunoadsorption involve nervous system diseases, autoimmune diseases, kidney diseases, hematological diseases, tumor diseases, liver diseases, metabolic diseases, connective tissue diseases, organ transplantation and many other fields. In terms of kidney diseases, such as acute glomerulonephritis, including anti-< P > glomerular basement membrane nephropathy and anti-neutrophil cytoplasmic antibody (ANCA)-related vasculitis involving the kidney, there are a large number of anti-glomerular basement membrane antibodies or ANCA in patients' blood circulation, which can rapidly and massively destroy glomeruli and even invade other important organs of the whole body, such as the lungs. The kidneys of patients can be completely destroyed within a few weeks, and the condition is extremely dangerous and the prognosis is extremely poor. However, if plasma exchange or immune adsorption is strengthened at the early stage of the disease, and drug treatment is combined, lives can be saved, and the renal function of many patients can basically return to normal. In thrombotic thrombocytopenic purpura/hemolytic uremic syndrome, there is a pathogenic substance called Von willebrand factor polymer in patients' blood, which may also include abnormal anti-endothelial cell antibodies and other pathogenic substances. When the disease involves the central nervous system and kidneys, it may endanger patients' lives. Timely and active plasma exchange therapy can often reverse the disease and save patients' lives. Multiple myeloma and light chain disease can cause acute renal failure. Intensive plasma exchange therapy can remove abnormal proteins in blood, reduce their deposition in the kidney and improve renal function. Systemic lupus erythematosus (SLE) can also involve all organs of the whole body, including the kidney and central nervous system, which is life-threatening in severe cases. Studies have found that plasma exchange or immune adsorption has therapeutic effects on SLE. Rejection reaction occurs after renal transplantation because there are a lot of abnormal antibodies in patients' blood that destroy the transplanted kidney. Whether it is a highly sensitive patient with a large number of abnormal antibodies before renal transplantation or a rejection patient with a large number of abnormal antibodies after transplantation, plasma exchange or immunoadsorption can be used to remove the antibodies, which can avoid the rejection of transplanted kidneys and protect the function of transplanted kidneys. In addition, plasma exchange also has a certain therapeutic effect on some special types of glomerulonephritis, such as focal segmental glomerulosclerosis.