William F. Clark, MD; A. Keith Stewart, MD; Gail A. Rock, MD; Marion Sternbach, MD; David M. Sutton, MD; Brendan J. Barrett, MD; A. Paul Heidenheim, MA; Amit X. Garg, MD; David N. Churchill, MD; the Canadian Apheresis Group
ClinicalTrials.gov identifier: NCT00120263.
Grant Support: By the Canadian Institute of Health Research, Gambro BCT, and The Kidney Foundation of Canada.
Potential Financial Conflicts of Interest: Grants received: W.F. Clark (Kidney Foundation of Canada, Canadian Institute of Health Research, Gambro BCT).
Requests for Single Reprints: William F. Clark, MD, London Health Sciences Centre, 800 Commissioners Road East, London, Ontario N6A 4G5, Canada.
Current Author Addresses: Drs. Clark and Garg and Mr. Heidenheim: London Health Sciences Centre, 800 Commissioners Road East, London, Ontario N6A 4G5, Canada.
Dr. Stewart: Princess Margaret Hospital, 620 University Avenue, Toronto, Ontario M5G 2C1, Canada.
Dr. Rock: The Ottawa Hospital, 1053 Carling Avenue, Ottawa, Ontario K1Y 4E9, Canada.
Drs. Sternbach and Churchill: McMaster University, St. Joseph's Hospital, 50 Charlton East, Hamilton, Ontario L8N 1A6, Canada.
Dr. Sutton: Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario M5C 2G4, Canada.
Dr. Barrett: Memorial University of Newfoundland, 300 Prince Philip Drive, St. Johns, Newfoundland A1B 3V6, Canada.
Author Contributions: Conception and design: W.F. Clark, A.K. Stewart, G.A. Rock, M. Sternbach, B.J. Barrett, A.P. Heidenheim, D.N. Churchill.
Analysis and interpretation of the data: W.F. Clark, A.K. Stewart, B.J. Barrett, A.P. Heidenheim, A.X. Garg, D.N. Churchill.
Drafting of the article: W.F. Clark, A.K. Stewart, A.P. Heidenheim, D.N. Churchill.
Critical revision of the article for important intellectual content: W.F. Clark, A.K. Stewart, M. Sternbach, D.M. Sutton, B.J. Barrett, A.P. Heidenheim, A.X. Garg, D.N. Churchill.
Final approval of the article: W.F. Clark, A.K. Stewart, A.X. Garg, D.N. Churchill.
Provision of study materials or patients: W.F. Clark, G.A. Rock, M. Sternbach, D.M. Sutton, D.N. Churchill.
Statistical expertise: W.F. Clark, A.P. Heidenheim, A.X. Garg, D.N. Churchill.
Obtaining of funding: W.F. Clark, A.K. Stewart, D.N. Churchill.
Administrative, technical, or logistic support: W.F. Clark, G.A. Rock.
Collection and assembly of data: W.F. Clark, A.P. Heidenheim, D.N. Churchill.
Clark WF, Stewart AK, Rock GA, Sternbach M, Sutton DM, Barrett BJ, et al. Plasma Exchange When Myeloma Presents as Acute Renal Failure: A Randomized, Controlled Trial. Ann Intern Med. 2005;143:777-784. doi: 10.7326/0003-4819-143-11-200512060-00005
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Published: Ann Intern Med. 2005;143(11):777-784.
Does plasma exchange benefit patients with multiple myeloma and renal failure?
This 6-month randomized trial involved 104 patients with acute renal failure at the onset of myeloma. A composite outcome of death, dialysis dependence, or severely reduced kidney function occurred in 57.9% of patients given 5 to 7 plasma exchanges and in 69.2% of patients given conventional therapy (difference, 11.3% [95% CI, −8.3% to 29.1%]).
Although these findings suggest no substantial benefits of plasma exchange, the wide 95% CI around the difference between groups means that large benefit or some harm is possible.
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Hematology/Oncology, Nephrology, Acute Kidney Injury, Multiple Myeloma.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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