Therapeutic Apheresis, Immunosuppression and Human Monoclonal Antibodies in Nephrology

Abstract

Most of the immunologic or non-immunologic renal diseases have a bad prognosis without treatment, and the treatment is complicated in these diseases. With the introduction of therapeutic apheresis, since more than 45 years, has led in combination with immunosuppressive therapies and/or human monoclonal antibodies to a steady increase in survival rates over the last years. Therapeutic apheresis is accepted as supportive therapy in all severe renal diseases such as acute kidney injury, nephrogenic systemic fibrosis, rapid progressive glomerulonephritis, hemolytic uremic hemolytic syndrome, and in renal transplant rejection. Other modern therapy concepts are different human monoclonal antibodies with or without therapeutic apheresis. For these renal disorders, besides the pathological aspect, the first-line and second-line therapies are shown. Therapeutic apheresis has been shown to effectively remove antibody, toxic substances and others from blood and lead to rapid improvement. The guidelines of the Apheresis Applications Committee of the American Society for Apheresis are cited.