Rheopheresis for severe peripheral arterial disease in hemodialysis patients: A clinical series
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 evalua...
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| Veröffentlicht in: | Journal of clinical apheresis 2022-02, Vol.37 (1), p.91-99 |
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| creator | Solignac, Justine Bataille, Stanislas Touzot, Maxime Bruner, Flora Bouchouareb, Dammar Brunet, Philippe Ridel, Christophe Robert, Thomas |
| description | 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, α2‐macroglobulin, total cholesterol, low‐density lipoprotein cholesterol, high‐density lipoprotein cholesterol, triglycerides, IgM, and estimated plasma viscosity (P |
| doi_str_mv | 10.1002/jca.21955 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_03777117v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2607577060</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3875-f51ddcaf3ec80c58fbf7cb0e8fb0ef1b3cfebc7152f9476de6392c070fe0d7613</originalsourceid><addsrcrecordid>eNp1kdFr2zAQxkVZadKuD_sHhmEv64PTk2X57L2F0K4rgUJZn4Usn4iCY3tSkpH_fnLTZTDo0919_O6Tjo-xTxxmHCC7XRs9y3gl5RmbcqjKlHPgH9gUUIg0y2U1YZchrAGgqoS8YBORl5hLhClTzyvqhxV5Ci4ktvdJoH2ckoG8G3XdJtpv4xCbxgXSgRLXJSva9E3UDuPaoLeOum34lswT07rOmQiHuEPhIzu3ug10_Vav2Mv93c_FQ7p8-v5jMV-mRpQoUyt50xhtBZkSjCxtbdHUQLEBsrwWxlJtkMvMVjkWDRWiygwgWIIGCy6u2M3Rd6VbNXi30f6geu3Uw3ypRg0EInKO-5H9emQH3__aUdiqjQuG2lZ31O-CygpAiQgFRPTLf-i63_kuXhKpLMccClH-e9z4PgRP9vQDDmpMSMWE1GtCkf385rirN9ScyL-RROD2CPx2LR3ed1KPi_nR8g_YzJqi</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2624740638</pqid></control><display><type>article</type><title>Rheopheresis for severe peripheral arterial disease in hemodialysis patients: A clinical series</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Solignac, Justine ; Bataille, Stanislas ; Touzot, Maxime ; Bruner, Flora ; Bouchouareb, Dammar ; Brunet, Philippe ; Ridel, Christophe ; Robert, Thomas</creator><creatorcontrib>Solignac, Justine ; Bataille, Stanislas ; Touzot, Maxime ; Bruner, Flora ; Bouchouareb, Dammar ; Brunet, Philippe ; Ridel, Christophe ; Robert, Thomas</creatorcontrib><description>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, α2‐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).</description><identifier>ISSN: 0733-2459</identifier><identifier>EISSN: 1098-1101</identifier><identifier>DOI: 10.1002/jca.21955</identifier><identifier>PMID: 34874570</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Aged ; Aged, 80 and over ; Amputation ; Apheresis ; Cholesterol ; Female ; Hematology ; Hemodialysis ; Human health and pathology ; Humans ; Life Sciences ; Male ; Middle Aged ; Peripheral Arterial Disease - surgery ; Peripheral Arterial Disease - therapy ; Plasmapheresis - methods ; Renal Dialysis ; Retrospective Studies ; Severity of Illness Index ; Time Factors ; Vein & artery diseases ; Viscosity</subject><ispartof>Journal of clinical apheresis, 2022-02, Vol.37 (1), p.91-99</ispartof><rights>2021 Wiley Periodicals LLC.</rights><rights>2022 Wiley Periodicals LLC.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3875-f51ddcaf3ec80c58fbf7cb0e8fb0ef1b3cfebc7152f9476de6392c070fe0d7613</citedby><cites>FETCH-LOGICAL-c3875-f51ddcaf3ec80c58fbf7cb0e8fb0ef1b3cfebc7152f9476de6392c070fe0d7613</cites><orcidid>0000-0002-3621-3329 ; 0000-0002-7580-0913</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjca.21955$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjca.21955$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34874570$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.inrae.fr/hal-03777117$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Solignac, Justine</creatorcontrib><creatorcontrib>Bataille, Stanislas</creatorcontrib><creatorcontrib>Touzot, Maxime</creatorcontrib><creatorcontrib>Bruner, Flora</creatorcontrib><creatorcontrib>Bouchouareb, Dammar</creatorcontrib><creatorcontrib>Brunet, Philippe</creatorcontrib><creatorcontrib>Ridel, Christophe</creatorcontrib><creatorcontrib>Robert, Thomas</creatorcontrib><title>Rheopheresis for severe peripheral arterial disease in hemodialysis patients: A clinical series</title><title>Journal of clinical apheresis</title><addtitle>J Clin Apher</addtitle><description>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, α2‐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).</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Amputation</subject><subject>Apheresis</subject><subject>Cholesterol</subject><subject>Female</subject><subject>Hematology</subject><subject>Hemodialysis</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Peripheral Arterial Disease - surgery</subject><subject>Peripheral Arterial Disease - therapy</subject><subject>Plasmapheresis - methods</subject><subject>Renal Dialysis</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Time Factors</subject><subject>Vein & artery diseases</subject><subject>Viscosity</subject><issn>0733-2459</issn><issn>1098-1101</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kdFr2zAQxkVZadKuD_sHhmEv64PTk2X57L2F0K4rgUJZn4Usn4iCY3tSkpH_fnLTZTDo0919_O6Tjo-xTxxmHCC7XRs9y3gl5RmbcqjKlHPgH9gUUIg0y2U1YZchrAGgqoS8YBORl5hLhClTzyvqhxV5Ci4ktvdJoH2ckoG8G3XdJtpv4xCbxgXSgRLXJSva9E3UDuPaoLeOum34lswT07rOmQiHuEPhIzu3ug10_Vav2Mv93c_FQ7p8-v5jMV-mRpQoUyt50xhtBZkSjCxtbdHUQLEBsrwWxlJtkMvMVjkWDRWiygwgWIIGCy6u2M3Rd6VbNXi30f6geu3Uw3ypRg0EInKO-5H9emQH3__aUdiqjQuG2lZ31O-CygpAiQgFRPTLf-i63_kuXhKpLMccClH-e9z4PgRP9vQDDmpMSMWE1GtCkf385rirN9ScyL-RROD2CPx2LR3ed1KPi_nR8g_YzJqi</recordid><startdate>202202</startdate><enddate>202202</enddate><creator>Solignac, Justine</creator><creator>Bataille, Stanislas</creator><creator>Touzot, Maxime</creator><creator>Bruner, Flora</creator><creator>Bouchouareb, Dammar</creator><creator>Brunet, Philippe</creator><creator>Ridel, Christophe</creator><creator>Robert, Thomas</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><general>Wiley</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0002-3621-3329</orcidid><orcidid>https://orcid.org/0000-0002-7580-0913</orcidid></search><sort><creationdate>202202</creationdate><title>Rheopheresis for severe peripheral arterial disease in hemodialysis patients: A clinical series</title><author>Solignac, Justine ; Bataille, Stanislas ; Touzot, Maxime ; Bruner, Flora ; Bouchouareb, Dammar ; Brunet, Philippe ; Ridel, Christophe ; Robert, Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3875-f51ddcaf3ec80c58fbf7cb0e8fb0ef1b3cfebc7152f9476de6392c070fe0d7613</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Amputation</topic><topic>Apheresis</topic><topic>Cholesterol</topic><topic>Female</topic><topic>Hematology</topic><topic>Hemodialysis</topic><topic>Human health and pathology</topic><topic>Humans</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Peripheral Arterial Disease - surgery</topic><topic>Peripheral Arterial Disease - therapy</topic><topic>Plasmapheresis - methods</topic><topic>Renal Dialysis</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>Time Factors</topic><topic>Vein & artery diseases</topic><topic>Viscosity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Solignac, Justine</creatorcontrib><creatorcontrib>Bataille, Stanislas</creatorcontrib><creatorcontrib>Touzot, Maxime</creatorcontrib><creatorcontrib>Bruner, Flora</creatorcontrib><creatorcontrib>Bouchouareb, Dammar</creatorcontrib><creatorcontrib>Brunet, Philippe</creatorcontrib><creatorcontrib>Ridel, Christophe</creatorcontrib><creatorcontrib>Robert, Thomas</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Journal of clinical apheresis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Solignac, Justine</au><au>Bataille, Stanislas</au><au>Touzot, Maxime</au><au>Bruner, Flora</au><au>Bouchouareb, Dammar</au><au>Brunet, Philippe</au><au>Ridel, Christophe</au><au>Robert, Thomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rheopheresis for severe peripheral arterial disease in hemodialysis patients: A clinical series</atitle><jtitle>Journal of clinical apheresis</jtitle><addtitle>J Clin Apher</addtitle><date>2022-02</date><risdate>2022</risdate><volume>37</volume><issue>1</issue><spage>91</spage><epage>99</epage><pages>91-99</pages><issn>0733-2459</issn><eissn>1098-1101</eissn><abstract>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, α2‐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).</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>34874570</pmid><doi>10.1002/jca.21955</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-3621-3329</orcidid><orcidid>https://orcid.org/0000-0002-7580-0913</orcidid></addata></record> |
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| ispartof | Journal of clinical apheresis, 2022-02, Vol.37 (1), p.91-99 |
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| subjects | Aged Aged, 80 and over Amputation Apheresis Cholesterol Female Hematology Hemodialysis Human health and pathology Humans Life Sciences Male Middle Aged Peripheral Arterial Disease - surgery Peripheral Arterial Disease - therapy Plasmapheresis - methods Renal Dialysis Retrospective Studies Severity of Illness Index Time Factors Vein & artery diseases Viscosity |
| title | Rheopheresis for severe peripheral arterial disease in hemodialysis patients: A clinical series |
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