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Abstract: SA-PO689

Comparison of Clinical Efficacy of Centrifugal-Membranous Hybrid Double Filtration Plasmapheresis and Membranous Double Filtration Plasmapheresis on Severe Lupus Nephritis

Session Information

Category: Glomerular Diseases

  • 1303 Glomerular Diseases: Clinical‚ Outcomes‚ and Trials

Authors

  • Dong, Jianhua, JinLing Hospital, Nanjing, Jiangsu, China
  • Huang, Li, JinLing Hospital, Nanjing, Jiangsu, China
  • Fan, Wenjing, JinLing Hospital, Nanjing, Jiangsu, China
  • Ge, Yongchun, JinLing Hospital, Nanjing, Jiangsu, China
Background

The Study delves into the clinical efficacy and safety of centrifugal- Membranous Hybrid double filtration plasmapheresis (C/M hybrid DFPP) on severe lupus nephritis (LN) by comparing it with membranous DFPP (M DFPP).

Methods

A retrospective cohort study was conducted in 70 patients who were diagnosed with severe LN and had received DFPP treatment from 2016 to 2021. 51patients received C/M hybrid DFPP, and 19 patients received M DFPP. The differences in clinical efficacy, vascular access, dosage of anticoagulant,treatment cost and adverse events were compared in the two types of DFPP.

Results

A total of 181 DFPPs ( 133 C/M hybrid DFPPs and 48 M DFPPs) were performed. The ANA, AdsDNA titer, quantitative urinary protein, urinary red blood cell count and serum creatinine decreased and hemoglobin increased after the DFPP treatment and at 3rd month after treatment, however, there was no significant difference between the two groups.All patients built the vascular access via the central venous catheter in M DFPP, while 8 patients built the vascular access via puncturing into the peripheral artery and vein in C/M hybrid DFPP. 34 patients (66.7%) received 4% citric acid alone for anti-coagulation in C/M hybrid DFPP, the dosage of LMWH was significantly lower than that in M DFPP(1204±286 vs 4106±399IU, P＜0.001).M DFPP had a significantly higher cost than C/M hybrid DFPP. 2 patients in M DFPP developed skin ectasis, epistaxis or aggravated alveolar hemorrhage, and 4 patients in C/M hybrid DFPP developed perioral numbness, numbness in distal extremities or tetany.

Conclusion

C/M hybrid DFPP could be a cost- effective treatment strategy applied in patients with severe LN.

Schematic diagram of Centrifugalmembranous hybrid DFPP

Schematic diagram of membranous hybrid DFPP