Cryoapheresis in cryoglobulinemic mesangiocapillary glomerulonephritis with acute renal failure

Aim. To assess cryoapheresis (CA) efficacy in the treatment of cryoglobulin emic glomerulonephritis (CG) with acute renal failure (ACR). Material and m ethods. Ten 34-64-year-old CG patients with associated HCV infection and sy mptoms of ACR (dieresis under 500 ml/day, serum creatinin 1.6-8.1 ml/dl). A ll the patients were examined clinically, for serum cryoglobulins, HCV HBV markers, morphologically (renal and hepatic biopsies in 8 patients). All th e patients received therapy with CA, immunodepressants. Three patients with virus replication received, in addition, antiviral drugs (alpha-interferon in a dose 3 000 - 000 5 000 000 IU 3 times a week intramuscularly for 6 mo nths). Results. CA in combined CG therapy led to fast elimination of cryoglobulins from the body, stabilization of renal function with arrest of rapid progre ssion of renal failure, normalization of diuresis with subsequent lowering of serum creatinin. The course of CA normalized renal function frilly in 3 patients, partially in 7 patients. Later, these 7 patients developed chroni c renal failure. Complete elimination of the virus and remission of CG were achieved in 2 of 3 patients who had undergone the antiviral treatment for a year. Conclusion. CA can be added to combined therapy of CG aggravation as it imp roves renal function.