Effects of renal replacement therapy combined with immune adsorption on inflammatory factors and immune function in patients with lupus nephritis

Objective To investigate the effect of renal replacement therapy combined with immune adsorption on inflammatory factors and immune function in patients with lupus nephritis.Methods Ninety-four patients with lupus nephritis were selected and randomly divided into the observation group and the control group (n=47 each group). The patients in two groups were treated with conventional hormone and immunosuppressant. The patients in the control group were treated with PH-350, and those in the observation group were treated with renal replacement therapy combined with immune adsorption for 4 courses (one week of one course). The inflammatory factors (TNF-alpha, IL-6, IL-8), immune function (IgG, IgA, IgM, C3, C4), systemic lupus erythematosus activity index (SLEDAI) and antibody levels (anti C1q antibody, anti nucleosome antibody and anti ds-DNA antibody) were compared between the two groups before and after treatment.Results Before treatment, there was no significant difference in the serum levels of TNF-alpha, IL-6 and IL-8 between the two groups (P>0.05). After treatment, TNF-alpha, IL-6 and IL-8 levels in two groups were decreased significantly as compared with those before treatment, and the levels of TNF-alpha, IL-6 and IL-8 in the observation group were significantly lower than those in the control group (P<0.05). Before treatment, the levels of IgG, IgA, IgM, C3 and C4 in the two groups were not statistically significant (P>0.05). After treatment, the IgG, IgA and IgM levels in two groups were significantly reduced, but C3, C4 complement levels were increased significantly. The levels of IgG, IgA and IgM in the observation group were significantly lower than those in the control group, but the levels of C3 and C4 were significantly higher than those in the control group (P<0.05). Before treatment, there was no significant difference between the two groups in SLEDAI score and anti C1q antibody, anti nucleosome antibody and anti ds-DNA antibody (P>0.05). After treatment, SLEDAI scores and the levels of anti ds-DNA antibody and anti C1q antibody, anti nucleosome antibody in the two groups were significantly decreased, and those in the observation group were significantly lower those in the control group (P<0.05).Conclusions Renal replacement therapy combined with immune adsorption can help reduce inflammation, improve immune function and reduce systemic lupus activity index and antibody level.