P180
PLASMA EXCHANGE AND OUTCOMES IN RENAL PATIENTS- OUR EXPERIENCE
Rajkumar Chinnadurai1, Kate Topping1, Adam Morris1 and Puchimada Uthappa1
1
Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford
INTRODUCTION: Plasma exchange is used in the treatment of autoimmune conditions in various
specialities.Our renal department is a major provider of therapeutic apheresis in the region providing
services both for renal and neurology patients. In renal medicine plasma exchange is mainly used to
treat vasculitis along with immunosuppression in particular for patients presenting with pulmonary
haemorrhage.
OBJECTIVES: To access the plasma exchange service delivered by renal department. To study the
outcomes in renal patients who had plasma exchange for vasculitis.
METHODS: All patients who received plasma exchange in our Hospital between July 2012 to June
2014 were collected from coding department. Renal patients were followed up for outcomes for a
period varying from 6 months to 18 months depending on the time of presentation. Data was collected
in Excel spreadsheet and analysed.
RESULTS: A total of 66 patients received plasma exchange over this 2 year time period of which 46
were from neurology, 18 from renal and 2 from haematology. Total number of sessions delivered was
242.Of the 18 renal patients 10 were males and 8 females. In 8 of 18patients, the underlying condition
was ANCA positive vasculitisand 2 had Anti-GBM disease .5 patients presented with pulmonary
haemorrhage. Albumin was the predominant replacement fluid with Fresh Frozen plasma and
Octoplas used in patients with pulmonary haemorrhage. At 6 months follow up 7 out of 8 ANCA
vasculitis patients recovered renal functions and 1 died. Both Anti-GBM patients ended up needing
long term Renal Replacement therapy despite plasma exchange and regular immunosuppression.
CONCLUSIONS:In our cohort of ANCA positive vasculitis patients who received Plasma Exchange
87.5% recovered renal functions. None of them were on Renal Replacement therapy at 6 months
follow up. Mortality rate was 12.5%