Turkish Journal of Nephrology
Original Article

The Effect of Plasma Exchange in Patients with Anti-neutrophil Cytoplasmic Antibody Associated Vasculitis: A Retrospective Analysis

1.

Department of Nephrology, University of Health Sciences, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey

2.

Department of Nephrology, Cukurova University Faculty of Medicine, Adana, Turkey

3.

Department of Nephrology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey

4.

Department of Nehrology, Baskent University, Faculty of Medicine, Ankara, Turkey

5.

Department of Nephrology, Dr Lutfi Kırdar Training Hospital, Istanbul, Turkey

6.

Department of Internal Medicine, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey

Turkish J Nephrol 1; 1: -
Read: 166 Published: 02 December 2021

Objective: Immunosuppressive therapy in ANCA-associated vasculitis (AAV) is indispensable for patient and kidney survival. There is a controversy about whether the risks of plasma exchange treatment override the probability of kidney-related outcomes. Hence the question arises in which conditions the plasma exchange will be required? In this study, we aimed to evaluate the effect of plasma exchange (PE) adding to immunosuppressive therapy in AAV patients. 

Methods: We retrospectively analyzed fifty-seven patients with biopsy-proven AAV. We grouped patients according to treatment options with or without PE. We investigate the 1- year and 5-year patient and kidney outcomes.  

Results: Thirty-six (63.2%) of 57 patients were treated with PE besides the routine immunosuppressive treatment. 16 (44.5%) of 36 patients were with active pulmonary hemorrhage and the remaining 20 (55.5%) were with vasculitic pulmonary involvement. The survival rate was 80.7% and 68.8% in the first and fifth year, respectively. In the multivariate Cox regression analysis model, risk factors affecting patient survival were age >50 years (HR=17.11 p=0.034), pulmonary involvement (HR=13.25 p=0.02), positive p-ANCA (HR=5.93 p=0.036), and lower albumin level (HR=0.18 p=0.014). It is found that C-reactive protein (CRP) level and plasma exchange did not relate to better patient and renal outcomes (p> 0.05).

Conclusions: In AAV, although pulmonary hemorrhage and pulmonary involvement are serious complications, plasma exchange did not provide additional benefit to standard treatment.  
 

EISSN 2667-4440