Clinical trial of plasma exchange with a membrane filter in treatment of crescentic glomerulonephritis

Abstract

Four patients with rapidly progressive crescentic glomerulonephritis were treated with repeated plasma exchanges, using a disposable plasma filter (PLASMAFLO), combined with immunosuppression and anticoagulation. A definite improvement of renal function was observed in two patients and complete recovery of the severe lung changes of Goodpasture's syndrome was seen in one of them. In another patient rapid progression of renal insufficiency was arrested. One patient with anuria at the start of treatment remained anuric. The filter was capable of removing as large a molecule as IgM, and the plasma concentrations of immunoglobulins and complement factors declined successively after each treatment. Plasma exchange with the filter technique is readily accessible and safe in hands of the hemodialysis staff. Easy availability and simplicity are important advantages over the centrifuge methods, considering that prompt commencement of the treatment is a key issue in success.