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Infectious complications with plasmapheresis in rapidly progressive glomerulonephritis
Abstract:
We recently used plasmapheresis to treat eight patients with rapidly progressive glomerulonephritis. Life-threatening infections developed in five patients, three of which were caused by opportunistic pathogens. In contrast, only two infections occurred in 21 patients with similar renal disease treated with immunosuppressive drugs but not with plasmapheresis. Although infectious complications of plasmapheresis therapy have not been amphasized previously, our experience, coupled with that of previous reports, suggests that serious infections will develop in one third of patients undergoing plasmapheresis for renal disease. Plasmapheresis should be used with caution in patients with rapidly progressive glomerulonephritis.
Insights
Plasmapheresis treatment for rapidly progressive glomerulonephritis led to severe infections in most patients. Alternative immunosuppressive drugs showed fewer infectious complications, suggesting caution with plasmapheresis.
Area of Science:
- Nephrology
- Immunology
- Infectious Diseases
Background:
- Rapidly progressive glomerulonephritis (RPGN) is a severe kidney disease.
- Plasmapheresis is a treatment option for certain kidney diseases.
- Infections are a known risk of immunosuppressive therapies.
Purpose of the Study:
- To evaluate the incidence of serious infections in patients with RPGN treated with plasmapheresis.
- To compare infection rates between plasmapheresis and other immunosuppressive treatments for RPGN.
Main Methods:
- Retrospective analysis of eight patients with RPGN treated with plasmapheresis.
- Comparison with a cohort of 21 patients with similar renal disease treated with immunosuppressive drugs without plasmapheresis.
- Documentation of all infectious complications, including pathogen type and severity.
Main Results:
- Five out of eight patients (62.5%) treated with plasmapheresis developed life-threatening infections.
- Three of these infections were caused by opportunistic pathogens.
- Only two infections occurred in 21 patients treated with immunosuppressive drugs alone.
Conclusions:
- Plasmapheresis therapy is associated with a high rate of serious infectious complications in patients with RPGN.
- Infectious complications, including those from opportunistic pathogens, should be closely monitored in patients undergoing plasmapheresis.
- Plasmapheresis should be used cautiously in the management of rapidly progressive glomerulonephritis due to the significant risk of infection.