In Japan, there are 24 indications for simple plasma exchange (PE); however, this number is lower than that in other countries. In addition, there have been few published studies dedicated to indications for simple PE in Japan.
This study aimed to elucidate the clinical background of patients who underwent PE at our hospital and examine its treatment course.
The study included patients who underwent PE in our department from January to December 2017. We retrospectively examined the data stored in the dialysis management system.
During the observational period, 42 patients [mean age, 49±18 years (mean±standard deviation); women, 52.4%] with 12 diseases underwent PE. Allogeneic kidney transplantation, which was the most common indication, was present in 17 (40.5%) patients. There were seven (16.6%) patients with focal glomerulosclerosis, seven (16.6%) patients with liver disease, and three (7.1%) patients with thrombotic microangiopathy. All the patients who underwent kidney transplantation, the renal function was maintained after kidney transplantation. In all patients with microangiopathy, the platelets increased and lactate dehydrogenase levels decreased. With respect to the adverse effects of the treatment, 19 (45.2%) patients experienced skin symptoms and two (4.8%) patients suffered from numbness.
We observed that PE performed at our hospital was effective for some of the indications. The outcome suggests that more studies reporting the indications for PE are required for expanding the number of indications for PE in Japan.
Aims: We aimed to clarify the relationship between maternal glucose metabolism and profiles of fatty acids.
Methods: We studied 102 Japanese women with singleton pregnancies. An oral glucose tolerance test (OGTT) was performed at 26.6±4.0 gestational weeks. The serum levels of triglycerides, total cholesterol, high- and low-density lipoprotein cholesterol, free fatty acid and polyunsaturated fatty acids (PUFAs) were measured in fasting blood samples. Fish intake was ascertained by a food-related questionnaire.
Results: OGTTs revealed that 14 subjects had gestational diabetes mellitus and 88 subjects had normal glucose tolerance. There was no significant difference in terms of age, body mass index before pregnancy, body weight gain from pre-pregnancy to the time of the OGTT, lipid levels, or frequency of fish consumption between the two groups. We found a positive correlation between fasting plasma glucose (FPG) and serum C-peptide levels and a negative correlation between FPG and docosahexaenoic acid (DHA) levels. FPG levels did not correlate with the frequency of fish consumption or eicosapentaenoic acid (EPA) levels. Multiple regression analysis showed that C-peptide (B = 1.415, p = 0.009) and DHA (B = −0.045, p = 0.003) levels independently related with FPG levels and free fatty acids levels (B = 0.054, p = 0.001) and fish consumption (B = 4.437, p = 0.034) independently related with 1 hour glucose levels.
Conclusions: FPG levels were negatively related with DHA levels, while there was no relationship between FPG levels and EPA levels, suggesting that these n-3 fatty acids are involved with plasma glucose levels via distinct mechanisms in pregnant women.