Abstract: SA-PO0779
Plasma Exchange Practices in ANCA-Associated Vasculitis in the United Kingdom (UK) and Ireland
Session Information
- Glomerular Research: Design, Registries, Surveys, and Epidemiology
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Kashif, Kinza, The University of Manchester Faculty of Biology Medicine and Health, Manchester, England, United Kingdom
- Hamilton, Patrick, Manchester University NHS Foundation Trust, Manchester, England, United Kingdom
- McAdoo, Stephen Paul, Imperial College London, London, England, United Kingdom
- Pusey, Charles D., Imperial College London, London, England, United Kingdom
- Brix, Silke R., The University of Manchester Faculty of Biology Medicine and Health, Manchester, England, United Kingdom
Background
The use of plasma exchange (PLEX) in anti-neutrophil cytoplasmic antibody (ANCA) vasculitis remains controversial. PLEX requires careful consideration of risks and benefits. While it may improve survival in life-threatening cases and enhance kidney recovery in selected cases of rapidly progressive glomerulonephritis (RPGN), these potential benefits must be balanced against the increased risk of severe infections.
Methods
We performed a UK and Ireland based online survey inquiring after the local practices of PLEX in ANCA vasculitis distributed via the UK and Ireland Vasculitis Society (UKIVAS), the UK Kidney Association (UKKA) and the British Society of Rheumatology Special Interest Group (BSR SIG).
Results
A total of 135 health care professionals participated (68% nephrologists, 20% rheumatologists, 89% consultant level). The survey asked whether PLEX was generally utilised for RPGN. 47% of the respondents stated that they used PLEX in RPGN, 38% were unsure and 15% said that they would not use PLEX in RPGN anymore. In cases where creatinine levels were greater than 300 µmol/L, 76% of participants stated they would not regularly use PLEX, 24% stated they would use PLEX routinely in these situations. Inquiring after usage in hypoxic diffuse alveolar haemorrhage (DAH), 77% used PLEX in hypoxic DAH while the residual participants did not.
When escalating to PLEX, most participants did not change the dosage of the glucocorticoid treatment (95%). Human albumin solution and fresh frozen plasma were mostly utilised as exchange solutions, but some participants used also cryoprecipitates (30%). Unfractionated heparin was the most used anticoagulation, but some used low molecular weight heparin and some citrate. Inquiring after routine safety checks, 79% checked fibrinogen levels regularly, 77% performed general coagulation profiles and 63% checked C reactive Proteins among other things.
Conclusion
Our survey demonstrated a significant variability in PLEX utilisation as well as variation in practical aspects performing PLEX in ANCA vasculitis. A practice aid might assist reducing treatment variability, increase practice standards with routine controls and improve health care experience and patient outcome.
Funding
- Government Support – Non-U.S.