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Role of plasmapheresis in the management of myeloma kidney: A systematic review.
MedLine Citation:
PMID:  20955270     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Multiple myeloma complicated by acute renal failure is a diagnosis often encountered by the practicing nephrologist. The role of plasmapheresis in such patients has been of interest for decades. Three randomized controlled trials (RCTs) and multiple observational trials have evaluated the potential role of plasmapheresis in the management of this condition. This systematic review presents the results of these trials regarding survival benefits, recovery from dialysis, and improvement in renal function. A comprehensive search revealed 56 articles. Of these, only 8 articles met our inclusion criteria (3 RCTs, 1 correction of results, and 4 observational trials). Two of the 3 RCTs showed no difference in survival benefit. Two of the 3 RCTs showed a greater percentage of patients stopping dialysis in the intervention group; however, these results were not reproduced in the largest trial. All the studies showed an improvement in renal function for patients receiving plasmapheresis; however, only 2 RCTs and 1 retrospective study showed a statistically significant improvement in renal function among patients who received plasmapheresis in comparison with a control group. Our systematic review does not suggest a benefit of plasmapheresis independent of chemotherapy for multiple myeloma patients with acute renal failure in terms of overall survival, recovery from dialysis, or improvement in renal function.
Authors:
Diptesh Gupta; Lohith Bachegowda; Gautam Phadke; Sue Boren; Diane Johnson; Madhukar Misra
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hemodialysis international. International Symposium on Home Hemodialysis     Volume:  14     ISSN:  1542-4758     ISO Abbreviation:  Hemodial Int     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101093910     Medline TA:  Hemodial Int     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  355-63     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors. Hemodialysis International © 2010 International Society for Hemodialysis.
Affiliation:
Department of Internal Medicine, School of Medicine, University of Missouri, Columbia, Missouri, USA.
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