Plasmapheresis application in ANCA-associated vasculitis characterized

According to a recent study, plasmapheresis was used in nearly 15% of adults hospitalized for newly diagnosed ANCA-associated vasculitis (AAV) with severe acute kidney involvement in the United States from 2016 to 2020.

Patients who received treatment were significantly more likely to experience acute kidney injury (AKI; 96% versus 90%), AKI requiring dialysis (52% versus 16%), hypoxia (40% versus 16%), and respiratory failure requiring mechanical ventilation (13% versus 3%) than those who did not receive treatment.

The findings come from an analysis of data from the National Inpatient Sample of 6,645 cases of adult hospitalizations for acute kidney involvement with a new diagnosis of AAV. Plasmapheresis was used in 975 cases (14.7%), reported Jianling Tao, MD, MS, of Stanford University School of Medicine in Palo Alto, California, and colleagues in Kidney360.

The treatment was used more frequently in patients in urban teaching hospitals than in rural and non-teaching hospitals. Plasmapheresis recipients had a significantly longer length of hospital stay than patients who did not receive the treatment (median 16.6 versus 8.9 days).

The researchers found no significant differences between groups in the use of plasmapheresis by geographic region, patient demographics, or comorbidities.

A 2024 practice guideline to improve global outcomes in kidney disease (KDIGO) recommends plasmapheresis as adjunctive therapy with high-dose corticosteroids, cytotoxic drugs, or targeted anti-B-cell therapies in AAV cases with a serum creatinine level above 3.4 mg/dL requiring dialysis or with rapidly rising serum creatinine levels, as well as in patients with diffuse alveolar hemorrhage and hypoxemia.