PMID- 34874570
OWN - NLM
STAT- MEDLINE
DCOM- 20220401
LR  - 20221207
IS  - 1098-1101 (Electronic)
IS  - 0733-2459 (Linking)
VI  - 37
IP  - 1
DP  - 2022 Feb
TI  - Rheopheresis for severe peripheral arterial disease in hemodialysis patients: A 
      clinical series.
PG  - 91-99
LID - 10.1002/jca.21955 [doi]
AB  - BACKGROUND: Rheopheresis is a double-filtration plasmapheresis that removes 
      high-molecular-weight molecules from the plasma and thereby lowers blood 
      viscosity. This treatment has been proposed in hemodialysis (HD) patients for 
      chronic limb-threatening ischemia (CLTI), but very few studies have evaluated the 
      usefulness of this technique. PRINCIPAL OBJECTIVE: To assess 1-year 
      amputation-free survival (AFS) of HD patients suffering from CLTI treated by 
      rheopheresis. MATERIAL AND METHOD: We conducted a retrospective study of 28 
      consecutive HD patients treated by rheopheresis in three French dialysis centers 
      between 1 February 2017 and 30 April 2019 in two indications resulting from CLTI, 
      namely chronic ulceration or recent minor amputation with delayed healing. 
      RESULTS: One-year AFS rate reached 53.6 (-19.8; +16.3)%. One-year overall 
      survival rate reached 67.9 (-20.5; +13.1)%. Main causes of death were infections 
      and related to palliative care implying reduction or withdrawal of regular 
      dialysis treatment. Hypotension episodes were the main rheopheresis adverse 
      events with a prevalence rate of 13.5%. Rheopheresis sessions significantly 
      reduced fibrinogen, C-reactive protein, alpha2-macroglobulin, total cholesterol, 
      low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, 
      triglycerides, IgM, and estimated plasma viscosity (P < .0001). CONCLUSION: 
      Rheopheresis may improve clinical outcomes of CLTI in HD patients. The assessment 
      of rheopheresis effectiveness needs to be confirmed by a multicenter randomized 
      controlled trial, such as the ongoing project in France (RHEO-PAD, NCT: 
      03975946).
CI  - (c) 2021 Wiley Periodicals LLC.
FAU - Solignac, Justine
AU  - Solignac J
AUID- ORCID: 0000-0002-3621-3329
AD  - Centre of Nephrology and Renal Transplantation, Hopital de la Conception, CHU de 
      Marseille, Marseille, France.
AD  - Aix Marseille Universite, INSERM, INRAE, C2VN, Marseille, France.
FAU - Bataille, Stanislas
AU  - Bataille S
AD  - Aix Marseille Universite, INSERM, INRAE, C2VN, Marseille, France.
AD  - Phocean Nephrology Institute, Clinique Bouchard, ELSAN, Marseille, France.
FAU - Touzot, Maxime
AU  - Touzot M
AD  - Centre of Dialysis Association pour utilisation du rein artificiel dans la region 
      parisienne (AURA) Saint Joseph, Hopital de Paris Saint Joseph, CHU de Paris V, 
      Paris, France.
FAU - Bruner, Flora
AU  - Bruner F
AD  - Aix Marseille Universite, INSERM, INRAE, C2VN, Marseille, France.
FAU - Bouchouareb, Dammar
AU  - Bouchouareb D
AD  - Centre of Nephrology and Renal Transplantation, Hopital de la Conception, CHU de 
      Marseille, Marseille, France.
FAU - Brunet, Philippe
AU  - Brunet P
AD  - Centre of Nephrology and Renal Transplantation, Hopital de la Conception, CHU de 
      Marseille, Marseille, France.
FAU - Ridel, Christophe
AU  - Ridel C
AD  - Centre of Dialysis Association pour utilisation du rein artificiel dans la region 
      parisienne (AURA) Saint Joseph, Hopital de Paris Saint Joseph, CHU de Paris V, 
      Paris, France.
FAU - Robert, Thomas
AU  - Robert T
AUID- ORCID: 0000-0002-7580-0913
AD  - Centre of Nephrology and Renal Transplantation, Hopital de la Conception, CHU de 
      Marseille, Marseille, France.
AD  - Service de nephrologie et transplantation, APHM, Hopital de la Conception, 
      Marseille, France.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20211207
PL  - United States
TA  - J Clin Apher
JT  - Journal of clinical apheresis
JID - 8216305
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Amputation, Surgical
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Peripheral Arterial Disease/surgery/*therapy
MH  - Plasmapheresis/*methods
MH  - *Renal Dialysis
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Time Factors
EDAT- 2021/12/08 06:00
MHDA- 2022/04/02 06:00
CRDT- 2021/12/07 12:30
PHST- 2021/11/07 00:00 [revised]
PHST- 2021/01/13 00:00 [received]
PHST- 2021/11/19 00:00 [accepted]
PHST- 2021/12/08 06:00 [pubmed]
PHST- 2022/04/02 06:00 [medline]
PHST- 2021/12/07 12:30 [entrez]
AID - 10.1002/jca.21955 [doi]
PST - ppublish
SO  - J Clin Apher. 2022 Feb;37(1):91-99. doi: 10.1002/jca.21955. Epub 2021 Dec 7.