Double Filtration Plasmapheresis for Extracorporeal Immunomodulation in Treatment of Rapidly Progressive Glomerulonephritis(Workshop1-12) :

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Rapidly progressive glomeruionephritis (RPG_TN) is a fatal disease if not treated early. Plasmapheresis is used for extracorporeal immunomodulation. This study has been conducted to ascertain plasmapheresis superiority. 14 cases of RPGN treated by double filtration plasmapheresis (DFPP) presenting with oligoanuria, fluid overload and severe uraemia for 2-10 weeks were studied. Renal biopsy disclosed crescent formation (56% 100%) and mesangial IgA&G deposition. Hemodialysis and immunosuppressive therapy failed. DFPP was started within one week of immunosuppressive therapy. 5 - 15 cycles were given to each patient, over a period of 10-45 days separating 1.2-1.4 litres of albumin-free plasma. 8 patients showed marked improvement in renal function biochemically and clinically. 4 patients died of sepeticemia. Hemodialysis was gradually withdrawn in the rest over 15-30 days. Repeat biopsy showed marked reduction in crescents (34% to 63%). Conclusion - DFPP is a superior lreatnient for RFGN, if instituted early.

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