Abstract: Objective To observe plasma adsorption (PA) for the treatment of severe lupus nephritis. Methods A total of 80 severe lupus nephritis patients confirmed by renal biopsy in the Urology Department of Meizhou City People's Hospital from Jan. 2011 to Dec. 2015 were recruited. They were divided into PA group and immunosuppressive group. Patients in the immunosuppressive group were treated with glucocortocoid and immunosuppressives. Patients in the PA group were treated with PA and immunosuppressives. Biochemical indicators, immune indices, inflammatory factors, and systemic lupus erythematosus disease activity index (SLEDAI score) were observed and compared before and after the treatment for 3 weeks. Results After PA, patients serum creatinine (t=0.377, P=0.021), blood urea nitrogen (t=0.351, P=0.030), and 24 hours urinary protein (t=0.417, P=0.012) decreased significantly. Serum IgG (t=2.553, P＜0.001), erythrocyte sedimentation rate (t=0.507, P=0.001), C-reactive protein (t=2.765, P＜0.001), and SLEDAI score (t=0.444, P=0.003) decreased significantly, as compared those before PA. Serum interleukin 4 (IL-4) (t=3.445, P<0.001), interleukin 6 (IL-6) (t=0.406, P=0.013) and tumor necrosis factor-α (TNF-α) (t=0.401, P=0.011) also decreased significantly. The overall effective rate in PA group was significantly higher than that of immunosuppressive group (χ2=23.667, P＜0.001). Conclusion Immunosuppressives combined with PA can quickly reduce serum antibodies and systemic lupus erythematosus disease activity, and acclerate the recovery from systemic lupus erythematosus. We recommend the use of PA for severe lupus nephritis patients.

Key words: Severe lupus nephritis, Plasma adsorption, Immunosuppressive therapy, SLEDAI score