Abstract
Treatment with steroids and immunosupressants is cmmonly effective for lupus nephritis. However, there are some patients who resist these treatments and have a serious prognosis. We have been reporting the efficacy of thrapeutic plasma exchange by fresh frozen plasma (FFP) for lupus nephritis. Evidence of the risk of hepatitis or the shortage of FFP is preventing the progress of this therapeutic trial. To get around these problems, we have been studying the therapeutic effects of double filtration plasma exchnge (DFPE) for lupus nephritis.
DFPE by using filters with two different pore sizes was applied for lupus nephritis. The patient's blood was drawn out and separated to psasma and corpuscles by a plasmaseparation filter (first filter). Then the separated plasma was passed through the second filter, which filtered out macromoleculer protein. The filtrated plasma was returned to the patient with the cells that had been separated by the first filter. The same volume of 5% albumin as drain out plasma was transfused to the patient.
Ten patients with lupus nephritis were treated by DFPE. The efficacy evaluations were good in seven, moderate in two and poor in one. Proteinuria was improved in seven out of eight patients after four weeks.
We conclude that the DFPE under the treatment with steroids and immunosupressants is effective for lupus nephritis. Further study will be needed to establish the indications for DFPE treatment in lupus nephritis.
