High Cut-off Protein-permeable membrane в лечении пациентов с плазмацитомой

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Clin J Am Soc Nephrol. 2009 Apr;4(4):745-54. Epub 2009 Apr 1.

Treatment of acute renal failure secondary to multiple myeloma with chemotherapy and extended high cut-off hemodialysis.
Hutchison CA, Bradwell AR, Cook M, Basnayake K, Basu S, Harding S, Hattersley J, Evans ND, Chappel MJ, Sampson P, Foggensteiner L, Adu D, Cockwell P.

Department of Nephrology, Queen Elizabeth Hospital, Birmingham, United Kingdom. [Ссылки доступны только зарегистрированным пользователям ]

BACKGROUND AND OBJECTIVES: Extended hemodialysis using a high cut-off dialyzer (HCO-HD) removes large quantities of free light chains in patients with multiple myeloma. However, the clinical utility of this method is uncertain. This study assessed the combination of chemotherapy and HCO-HD on serum free light chain concentrations and renal recovery in patients with myeloma kidney (cast nephropathy) and dialysis-dependent acute renal failure. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: An open-label study of the relationship between free light chain levels and clinical outcomes in 19 patients treated with standard chemotherapy regimens and HCO-HD. RESULTS: There were sustained early reductions in serum free light chain concentrations (median 85% [range 50 to 97]) in 13 patients. These 13 patients became dialysis independent at a median of 27 d (range 13 to 120). Six patients had chemotherapy interrupted because of early infections and did not achieve sustained early free light chain reductions; one of these patients recovered renal function (at 105 d) the remaining 5 patients did not recover renal function. Patients who recovered renal function had a significantly improved survival (P < 0.012). CONCLUSION: In dialysis-dependent acute renal failure secondary to myeloma kidney, patients who received uninterrupted chemotherapy and extended HCO-HD had sustained reductions in serum free light chain concentrations and recovered independent renal function.

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Сейчас проводим high cut-off hemodialysis одному из наших пациентов с myeloma kidney (cast nephropathy) and dialysis-dependent acute renal failure. Посмотрим, что из этого получится...