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Harada-Shiba M. Treating PAD Patients with Lipoprotein Apheresis. J Atheroscler Thromb 2024; 31:1365-1366. [PMID: 39111842 PMCID: PMC11456352 DOI: 10.5551/jat.ed269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Accepted: 07/22/2024] [Indexed: 10/04/2024] Open
Affiliation(s)
- Mariko Harada-Shiba
- Cardiovascular Center, Osaka Medical and Pharmaceutical University, Osaka, Japan
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Hoshikawa Y, Ohkubo A, Sakurasawa T, Usui M, Deushi M, Yamamoto H, Naito S. Investigation of treatment volume versus circulating blood volume during Rheocarna treatment. Ther Apher Dial 2024; 28:505-510. [PMID: 38453633 DOI: 10.1111/1744-9987.14117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 02/19/2024] [Indexed: 03/09/2024]
Abstract
INTRODUCTION Rheocarna's therapeutic effect is associated with fibrinogen (Fib) and low-density lipoprotein cholesterol (LDL-C) adsorptive removal. This study aimed to retrospectively investigate the association between treatment volume (TV) and circulating blood volume (CBV) and the Fib removal rate (Fib-RR) and LDL-C-RR. METHODS CBV and TV/CBV, cut-off value (CO value), and area under the receiver operating characteristic (ROC) curve (AUC) were calculated. The Fib-RR and LDL-C-RR at the midterm and end of treatment were compared. The groups were further categorized into three groups with TV/CBV lower than or higher than the CO value at the midterm and end (midterm/end; Group L: lower than/lower than CO; Group L/H: lower than/higher than CO; Group H: higher than/higher than CO), and the Fib-RR and LDL-RR of each group at the midterm and end were compared. RESULTS ROC analysis revealed a TV of 1.480 times the BV as CO value, which showed a maximum Youden index predicting a Fib-RR of 20% (AUC: 0.828). Among the three groups, Group L and Group L/H demonstrated significantly higher Fib-RR and LDL-C-RR at the end of the study than in the midterm, while Group H exhibited no difference. CONCLUSION The results reveal that a treatment volume of 1.5 times the circulating blood volume is a sufficient solute removal capacity in the Rheocarna-enabled cases.
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Affiliation(s)
- Yuki Hoshikawa
- Medical Engineering Center, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Atsushi Ohkubo
- Medical Engineering Center, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Takatoshi Sakurasawa
- Medical Engineering Center, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Mana Usui
- Medical Engineering Center, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Masaya Deushi
- Medical Engineering Center, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Hiroko Yamamoto
- Medical Engineering Center, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Shotaro Naito
- Department of Nephrology, Tokyo Medical and Dental University, Tokyo, Japan
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Handa T, Fujii M, Ando M, Masuda M, Sokai Y, Tsuji Y, Fukuda Y, Ohue K, Higashi Y, Mori KP, Endo T, Tsukamoto T. Correlation between bradykinin concentration and blood pressure during Rheocarna therapy: A single-center case series. Ther Apher Dial 2024; 28:453-459. [PMID: 38173128 DOI: 10.1111/1744-9987.14105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/13/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION A novel LDL (low-density lipoprotein) apheresis therapeutic option, Rheocarna, has garnered attention as an alternative therapy for chronic limb-threating ischemia (CLTI). Bradykinin-mediated vasodilation is involved in the effects of LDL apheresis and a decrease in blood pressure (BP), but the changes in bradykinin concentration during Rheocarna therapy are unknown. METHODS The study involved patients with CLTI treated with Rheocarna at our hospital, from April 2022 to August 2023. RESULTS After Rheocarna therapy, skin ulcers improved in 80% of the patients. Circuit coagulation was observed in two patients with high fibrinogen levels. A decrease in BP was observed at approximately the same time when the bradykinin concentration peaked. The peak bradykinin concentration in a patient undergoing hemodialysis at the same time was considerably lower than that in the other patients. CONCLUSION This is the first report on the changes in bradykinin concentration under Rheocarna therapy.
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Affiliation(s)
- Takaya Handa
- Department of Nephrology and Dialysis, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai, Osaka, Japan
| | - Masaki Fujii
- Department of Clinical Engineering, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai, Osaka, Japan
| | - Masumi Ando
- Department of the Blood Purification Center of Kitano Hospital, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai, Osaka, Japan
| | - Mayumi Masuda
- Department of the Blood Purification Center of Kitano Hospital, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai, Osaka, Japan
| | - Yuko Sokai
- Department of Clinical Engineering, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai, Osaka, Japan
| | - Yoshiki Tsuji
- Department of Clinical Engineering, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai, Osaka, Japan
| | - Yui Fukuda
- Department of Nephrology and Dialysis, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai, Osaka, Japan
| | - Kaoru Ohue
- Department of Nephrology and Dialysis, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai, Osaka, Japan
| | - Yoshiaki Higashi
- Department of Nephrology and Dialysis, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai, Osaka, Japan
| | - Keita P Mori
- Department of Nephrology and Dialysis, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai, Osaka, Japan
| | - Tomomi Endo
- Department of Nephrology and Dialysis, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai, Osaka, Japan
| | - Tatsuo Tsukamoto
- Department of Nephrology and Dialysis, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai, Osaka, Japan
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