Clinical observation of different ways of blood purification combined with immune inhibitors for the treatment of serious lupus nephritis

Objective To observe the immune function and clinical curative effect of the different ways of blood purification combined immunosuppressor for the treatment of patients with serious lupus nephritis.Methods 35 patients diagnosed with serious lupus nephritis were divided into continuous veno-venous hemofiltration(CVVH)+conventional medical treatment group(treatment group) and hemodialysis(HD)+conventional medical treatment group(control group). The changes in ANA titer, anti-ds-DNA antibodies, C3, erythrocyte sedimentation rate (ESR), serum creatinine (SCr) and 24-h urinary protein quantity were compared between the two groups before and after treatment. The therapeutic effect and pathological changes of the renal biopsy were statistically compared between two groups.Results The ANA titer, anti-ds-DNA antibodies, C3, ESR, SCr and 24-h urinary protein quantity had no statistically significant difference between the two groups on the first day after admission (P>0.05). After treatment for 1 month, the ANA titer, anti-ds-DNA antibodies, ESR, SCr and 24-h urinary protein quantity in the two groups were decreased significantly as compared with those pre-treatment (P<0.05). There was significant difference in the ANA titer, anti-ds-DNA antibodies, ESR and SCr between two groups (P<0.05), but there was no significant difference in the 24-h urinary protein quantity (P>0.05). After treatment for 1 month, C3 levels were elevated, and there was significant difference in the treatment group before and after treatment, and between two groups(P<0.05). The respective index(AI), chronic index(CI) and tubulointerstitial lesions(TIL) scores had no statistically significant difference between the two groups. The dialysis days were shorter, and the treatment efficiency after 6 months was higher in the treatment group than in the control group.Conclusions CVVH therapy can improve the patient's immune indexes, has good clinical efficacy, compared with ordinary HD therapy treatment time shortened, the earlier from dialysis, could help patients with renal function recovery, and the illness is more stable.