title: Removal of focal segmental glomerulosclerosis (FSGS) factor suPAR using CytoSorb.
abstract: Treatment of primary focal segmental glomerulosclerosis (FSGS) and its recurrence after kidney transplantation associated with rapid deterioration of kidney function remains to be challenging despite advances in immunosuppressive therapy. The presence of circulating factors has been postulated to be a pivotal player in the pathogenesis of FSGS, although suPAR and CLCF-1 have been identified as the most promising causative factors. The potential therapeutic effect of suPAR elimination in an FSGS patient using CytoSorb, a hemoadsorption device that gained attention in the cytokine elimination in septic patients, was studied. Efficiency of total plasma exchange to remove suPAR was determined. CytoSorb hemoadsorption caused a 27.33% reduction of the suPAR level in a single treatment, whereas total plasma exchange showed a suPAR level reduction of 25.12% (n = 3; 95% confidence interval, 0.2777-0.8090; P < 0.01), which may indicate therapeutic potential in the treatment of primary FSGS and its recurrence in a kidney transplant.
authors.affiliation: Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.
authors.forename: Heiko
authors.identifier: http://orcid.org/0000-0003-2693-5712
authors.initials: H
authors.lastname: Schenk
authors.affiliation: Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.
authors.forename: Janina
authors.identifier: http://orcid.org/0000-0001-6081-5664
authors.initials: J
authors.lastname: Müller-Deile
authors.affiliation: Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.
authors.forename: Roland
authors.initials: R
authors.lastname: Schmitt
authors.affiliation: Institute for Pathology, Hannover Medical School, Hannover, Germany.
authors.forename: Jan Hinrich
authors.identifier: http://orcid.org/0000-0002-2600-1883
authors.initials: JH
authors.lastname: Bräsen
authors.affiliation: Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Haller
authors.affiliation: Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.
authors.forename: Mario
authors.identifier: http://orcid.org/0000-0002-8414-1470
authors.initials: M
authors.lastname: Schiffer
mesh_terms: D000327:Adsorption; D000328:Adult; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000628:therapy*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects; D010951:Plasma Exchange / Q000379:methods; D055293:Receptors, Urokinase Plasminogen Activator / Q000302:isolation & purification*; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D055293:Receptors, Urokinase Plasminogen Activator
keywords: CytoSorb; FSGS; plasmapheresis; podocytes; podocyturia; suPAR