A Review of Controlled Trials Using Therapeutic Apheresis in Nephrology

Abstract

The role of therapeutic apheresis (TA) in renal diseases has long been under discussion, and although being the absolute numbers unchanged over the past 10–15 years, the indications have considerably changed. Many therapeutic changes have relied upon the demonstration, or lack of demonstration, of underlying mechanisms that would benefit from the use of plasma removal and/or treatment. In the literature there is a considerable criticism on the use of TA in nephrology, due to a lack of randomized controlled trials (RCT) and to the predominance of low-quality evidence. There are 4 different areas of interest for TA in nephrology, i.e. glomerular diseases, kidney transplantation, secondary nephropathies, and technical advances. To determine an improvement in the quality and quantity of evidence, the Clinicaltrials. gov database was searched at the end of 2012 for actively recruiting TA-RCT in nephrology.