[Cryoapheresis in the treatment of patients with cryoglobulinemic mesangiocapillary glomerulonephritis and acute kidney failure].
OBJECTIVE
To assess cryoapheresis (CA) efficacy in the treatment of cryoglobulinemic glomerulonephritis (CG) with acute renal failure (ACR).


METHODS
Ten 34-64-year-old CG patients with associated HCV infection and symptoms of ACR (diuresis under 500 ml/day, serum creatinin 1.6-8.1 ml/dl). All the patients were examined clinically, for serum cryoglobulins, HCV, HBV markers, morphologically (renal and hepatic biopsies in 8 patients). All the patients received therapy with CA, immunodepressants. Three patients with virus replication received, in addition, antiviral drugs (alpha-interferon in a dose 3,000,000-5,000,000 IU 3 times a week intramuscularly for 6 months).


RESULTS
CA in combined CG therapy led to fast elimination of cryoglobulins from the body, stabilization of renal function with arrest of rapid progression of renal failure, normalization of diuresis with subsequent lowering of serum creatinin. The course of CA normalized renal function fully in 3 patients, partially in 7 patients. Later, these 7 patients developed chronic renal failure. Complete elimination of the virus and remission of CG were achieved in 2 of 3 patients who had undergone the antiviral treatment for a year.


CONCLUSIONS
CA can be added to combined therapy of CG aggravation as it improves renal function.
Milovanov
Iu S
IuS
Komiagin
Iu V
IuV
Kozlovskaia
L V
LV
Gordovskaia
N B
NB
D058186:Acute Kidney Injury / Q000628:therapy*; D000328:Adult; D001781:Blood Component Removal / Q000379:methods; D003449:Cryoglobulinemia / Q000150:complications / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D015432:Glomerulonephritis, Membranoproliferative / Q000628:therapy*; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007372:Interferons / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D013997:Time Factors
D007372:Interferons