#4583 NEUROLOGICAL DISEASES TREATED WITH PLASMAPHERESIS PERFORMED BY NEPHROLOGISTS

Abstract

Abstract Background and Aims Apheresis is an extracorporeal technique whose objective is to eliminate pathological elements considered to be responsible for a disease or its clinical manifestations. Plasmapheresis is part of the nephrology activity that will precise to be promoted within clinical practice. It is a therapeutic alternative for a large number of diseases, with certain neurological pathologies being the most benefited of its use. The purpose of this study is to describe the experience with plasmapheresis performed by nephrologists on patients with neurological diseases. Method Descriptive-retrospective study of neurological diseases treated with plasmapheresis in our nephologist section between the years 2008-2023. We analyzed demographic data, underlying disease, procedure, complications, and clinical response of the patients. Results A total number of 31 plasmapheresis procedures have been performed, of which 16 procedures have been performed in neurological diseases with a total of 92 sessions. The average age was 47 years, with 69% of the female sex predominance. The most frequently disease treated was Multiple Sclerosis with 31%, followed by Acute demyelinating polyneuropathy in the form of Guillain Barré with 25%, Myasthenia Gravis and Voltage-Gated Potassium Channel Antibody Related antiLGi-1, both with 13%. Treatment prior to the technique was corticosteroids with 75%, immunoglobulins with 56% and immunosuppressants with 13%. All sessions were performed using the transmembrane filtration technique with plasmaFlux® and the Fresenius mulitiFiltrate® equipment. The median number of sessions per patient was 6. The mean exchange volume was 2.9 l/patient/session. The replacement fluid used was albumin on 100% of patients and 4 patients required albumin plus fresh frozen plasma. 75 percent of the patients had a positive response with partial remission or stability of the disease and 88 percent had no recurrences. Patients’ neurological response to the therapy was the expected, and similar to the one reported in the medical literature. Conclusion In our experience, plasmapheresis is a safe and effective therapy in patients with neurological diseases that should be required as a therapeutic option. We, as nephrologists must be aware of this and promote the management of this technique by publishing the joint experience in order to broaden the level of evidence in clinical practice. The importance of coordination in early referral by other different medical specialties may obtain better results.