title: Combined dialysis and plasma-exchange in acute renal failure.
abstract: Combined use of plasma-exchange and dialysis therapy in 3 different cases of acute renal failure is presented. The first is a case of acute renal failure due to rhabdomyolysis caused by hemlock poisoning. Plasma-exchange was effective in improving the signs of rhabdomyolysis and renal failure. The second is a case of acute renal failure in an IgG-kappa myeloma. After 9 sessions of plasma-exchange, performed simultaneously with CAPD, a significant fall in the plasma and urine light chains levels was obtained. After the recovery of normal renal function, CAPD was prosecuted to remove light chains. The last is a case of acute renal failure in a patient with a mesangiocapillary nephritis and a high level of circulating immune complexes (CIC). He underwent steroid therapy and daily sessions of hemodialysis, followed by plasma-exchange, which permitted a fall of the CIC level, until a normal renal function was achieved. In conclusion, plasma-exchange combined with dialysis, is an useful tool for the management of acute renal failure caused by toxic proteins.
authors.affiliation: Division of Nephrology, Regional Hospital, Taranto, Italy.
authors.forename: N E
authors.initials: NE
authors.lastname: Montemurro
authors.forename: A
authors.initials: A
authors.lastname: Di Maggio
authors.forename: P
authors.initials: P
authors.lastname: Strippoli
authors.forename: F
authors.initials: F
authors.lastname: Coviello
authors.forename: F
authors.initials: F
authors.lastname: Godino
authors.forename: G
authors.initials: G
authors.lastname: Miloro
authors.forename: A
authors.initials: A
authors.lastname: Scatizzi
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology / Q000628:therapy*; D000328:Adult; D001781:Blood Component Removal; D001798:Blood Proteins / Q000302:isolation & purification*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009846:Oliguria / Q000150:complications*; D010951:Plasma Exchange; D006435:Renal Dialysis
chemical_list: D001798:Blood Proteins