| Theme |
Acute Blood Purification Therapy |
| Title |
Recent aspects of adsorption therapy |
| Author |
Tsukasa Nakamura |
Division of Nephrology, Department of Medicine, Shinmatsudo Central General Hospital |
| Author |
Hikaru Koide |
Division of Nephrology, Department of Medicine, Koto Hospital |
| Author |
Yoshihiko Ueda |
Department of Pathology, Koshigaya Hospital, Dokkyo University School of Medicine |
| Author |
Koichi Node |
Department of Cardiovascular and Renal Medicine, Saga University |
| [ Summary ] |
Blood adsorption therapies are commonly performed in the dialysis centers of general hospitals and dialysis clinics. It is necessary for dialysis staffs to understand the mechanisms and recent aspects of adsorption therapy. Low density lipoprotein (LDL) apheresis is useful in treatment of focal glomerular sclerosis (FGS), familiar hypercholesterolemia (FH) and arteriosclerosis obliterans (ASO).
Atherosclerotic lesions maybe severe in dialysis patients. There is growing evidence that LDL apheresis is effective for patients receiving hemodialysis and having ASO complications. Recently, LDL apheresis has come to be accepted as effective for patients suffering from sudden sensorineural hearing loss. Granulocyte and monocyte apheresis (GMA apheresis) is useful in treating inflammatory bowel diseases such as ulcerative colitis (UC). Meta-analysis of seven randomized controlled trials including 594 patients, indicated that GMA apheresis induces clinical remission in a higher proportion of UC patients as compared to conventional medical therapy. Septic shock remains a major cause of death in intensive care units. Despite intense research, a new drug which is effective in reducing mortality in septic shock cases is still needed (Leone, M., et al., Expert Opinion on Emerging Drugs). PMX-DHP has been developed in Japan and this therapy for treating useful in septic shock and respiratory diseases such as interstitial pneumonitis. This therapy is uncommon in dialysis clinics. Recent aspects of PMX-DHP are introduced. |