PLASMAPHERESIS USING CASCADE FILTRATION (CF)

Abstract

Cascade Filtration (CF) consists of a double filter system. The separated plasma is pumped into a hollow fibers filter with a nominal cut-off of 600 kd, that retained bigger proteins in hollow fibers. The CF is effective in the cast nephropathy, in Waldenstrom's macroglobulinemia, in active cryoglobulinemia. CF is used successfully in Guillain-Barrè. Syndrome (GBS), Myasthenia Gravis (MG), hypercholesterolemia, Focal Segmental Glomerulosclerosis (FSCS) and recently in the Age-related Macular Degeneration (AMD). We report our experience on 23 patients with different diseases. In seven out often cryoglobulinemic patients, we observed an improvement of renal function after six sessions of 1.5 plasma volume CF in two weeks. In 4 patients with GBS and in 2 patients with acute renal failure due to Multiple Myeloma, there was a complete recovery. Three patients with FSGS with massive proteinuria underwent to CF plasmapheresis. After six treatments, the nephrotic syndrome disappeared in two of them; in the third the proteinuria decreases from 11 gr/die to 4 gr/die. One patient with an acute renal failure due to rhabdomyolysis, recovered renal function after seven sessions. One patient with Systemic Lupus Erythematosus and severe arthralgia underwent to five CF sessions with remission of arthralgia. In two patients with Hypercholesterolemia we observed the reduction of cholesterol levels. In conclusion, we believe that the CF is an effective, safety and low costs technique in different diseases, with the advantages of a selective removal without infusion of exogenous fluids.