Blood Purification最新文献

{"title":"Lights and Shadows of Surviving Sepsis Campaign Recommendations.","authors":"Claudio Ronco, Vedran Premuzic","doi":"10.1159/000553535","DOIUrl":"10.1159/000553535","url":null,"abstract":"","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-4"},"PeriodicalIF":2.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Volume Hemofiltration: What Are the Last Indications in 2026? - A Narrative Review.","authors":"Julien Moury, Sebastien Redant, Willem Boer, Patrick M Honoré","doi":"10.1159/000553509","DOIUrl":"10.1159/000553509","url":null,"abstract":"<p><strong>Background: </strong>High-dose continuous therapies and especially high-volume hemofiltration have failed to demonstrate clinical benefit in septic shock and are, therefore, no longer recommended in this setting. However, extrapolating this negative conclusion to all clinical indications may be inappropriate.</p><p><strong>Summary: </strong>This narrative review revisits the current and emerging indications for high-dose continuous therapies beyond sepsis, focusing on pathophysiological rationale and toxin kinetics. Recent evidence, notably the CONVINCE trial, has established high-volume intermittent post-dilution online hemodiafiltration as superior to conventional hemodialysis in chronic kidney disease, likely through enhanced removal of middle and protein-bound uremic toxins. In acute settings, high-dose continuous therapy strategies play a critical neuroprotective role in hyperammonemia - both hepatic and non-hepatic - as well as in selected severe drug intoxications, including valproate, metformin, and lithium.</p><p><strong>Key messages: </strong>When appropriately selected and adequately dosed, high-dose continuous therapies remain powerful, targeted tools in modern blood purification.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Peritoneal Dialysis: Applications, Algorithms, and Future Directions.","authors":"Jose Arriola-Montenegro, Tamar Ratishvili, Andrea Kattah","doi":"10.1159/000553474","DOIUrl":"10.1159/000553474","url":null,"abstract":"<p><strong>Background: </strong>Peritoneal dialysis (PD) naturally lends itself to artificial intelligence (AI) due to its generation of dense, longitudinal, and structured data. PD outcomes are strongly influenced by modifiable factors such as dialysate composition, dwell time, and fluid balance, making prediction directly actionable.</p><p><strong>Summary: </strong>Recent investigations have demonstrated the potential of machine learning and deep learning approaches across multiple domains of PD care. Applications include pre-dialysis patient stratification, prediction of technique failure, monitoring of dialysis adequacy, and assessment of fluid status. AI models have also been developed for forecasting the causative pathogen in peritonitis and prediction of complications, hospitalizations, and mortality, frequently outperforming conventional statistical methods. In parallel, AI-driven chatbots and digital platforms have shown promise in enhancing patient education, engagement, and adherence. While these findings highlight significant potential, most studies to date are single-center, exploratory, and limited in scale, underscoring the need for rigorous external validation and systematic clinical implementation.</p><p><strong>Key messages: </strong>AI holds considerable promises for improving outcomes in PD by enabling risk identification, individualized therapy, and strengthened patient support. Future directions include integration with electronic health records, remote monitoring, and multi-omics data. Careful validation, ethical safeguards, and equitable deployment will be essential to realize AI's role as a transformative tool in PD care.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing the Priming Process for Hemoadsorption Combined with Hemodialysis: A Two-Stage in vitro and Clinical Validation Study.","authors":"Lingling Liu, Yanqing Jie, Xiaojing Tang, Suhua Shi, Anna Lorenzin, Zhiguo Mao, Lin Li, Haoran Liu, Xiaoyan Zheng, Xiaohong Xing, Bing Dai, Jing Chen","doi":"10.1159/000553476","DOIUrl":"10.1159/000553476","url":null,"abstract":"<p><strong>Introduction: </strong>Conventional priming for hemoadsorption combined with hemodialysis is complex, time-consuming, and resource-intensive. We aimed to develop and validate a standardized, efficient, and safe tandem priming protocol by systematically evaluating its operational efficiency, circuit cleanliness, clinical efficacy, and clinical safety.</p><p><strong>Methods: </strong>A two-stage \"in vitro screening - clinical validation\" design was utilized, using the HA130 hemoadsorption cartridge (Jafron, China) throughout all experiments and clinical sessions. The in vitro phase compared four novel tandem priming methods (varying slow-prime flow rates and fast-flush volumes) against a traditional separate-priming method to identify an optimal protocol based on efficiency and cleanliness. This protocol was then validated in a single-center, single-blind randomized controlled trial involving 53 maintenance hemodialysis patients randomized to the optimized tandem method (n = 29) or the traditional method (n = 24). The primary safety outcome was circuit clotting; the primary efficacy outcome was solute clearance.</p><p><strong>Results: </strong>In vitro, all tandem methods were significantly faster (26.05-34.89 min vs. 55.40 min, p < 0.001) and consumed fewer resources while meeting all cleanliness standards. After preliminary safety screening excluded a faster flow rate (100 mL/min), the 50-mL/min slow-prime with 2,000-mL fast-flush protocol was selected. In the clinical trial, the incidence of grade I cartridge clotting was low and statistically comparable between the tandem (3.45%) and traditional (4.17%) groups (p > 0.05). Solute reduction values for urea, creatinine, and β₂-microglobulin were not significantly different, demonstrating comparable therapeutic efficacy.</p><p><strong>Conclusion: </strong>The novel tandem priming protocol is a highly efficient, resource-sparing, and safe alternative to traditional methods. It maintains therapeutic efficacy and circuit patency, offering a valuable, standardized solution for clinical practice.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-12"},"PeriodicalIF":2.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Changes after Tenapanor Initiation in Maintenance Hemodialysis Patients: A Two-Center Retrospective Observational Study.","authors":"Syu Iwasawa, Takeshi Nakanishi, Takahiro Kuragano","doi":"10.1159/000553109","DOIUrl":"10.1159/000553109","url":null,"abstract":"<p><strong>Introduction: </strong>Hyperphosphatemia is common in patients on hemodialysis. It is often difficult to control because of high pill burden and adverse effects of phosphate binders. Tenapanor, an inhibitor of intestinal Na+/H+ exchanger isoform 3 (NHE3), reduces paracellular phosphate transport. Here, we assessed tenapanor's effectiveness in routine hemodialysis practice.</p><p><strong>Methods: </strong>Our retrospective observational study was done at two outpatient centers in Japan. Forty-one adults on maintenance hemodialysis started tenapanor (5 mg twice daily). Patients who discontinued the drug due to diarrhea were not included in the study. For each patient, the baseline evaluation means for 12 weeks were compared with the 12-week evaluation means after a stabilization period. Outcomes were serum phosphate and other biochemistry parameters, phosphate binder tablet count and phosphate-binding capacity (PBC), interdialytic weight gain (IDWG), and blood pressure. Paired differences and associations among metrics changes (Δ) were tested.</p><p><strong>Results: </strong>Serum phosphate decreased from 6.5 ± 1.2 to 5.4 ± 1.3 mg/dL (p < 0.001). Binder tablet intake and PBC decreased significantly. IDWG declined from 3.1 ± 1.1 to 2.9 ± 1.0 kg (p = 0.016). Systolic and diastolic blood pressure also decreased significantly. Of note, Δ IDWG correlated with Δ phosphate (r = 0.35, p = 0.024).</p><p><strong>Conclusion: </strong>In patients on hemodialysis, the addition of tenapanor was associated with the improvement of phosphate control and reduced binder burden and PBC. It was also linked with a reduction of IDWG modestly, but significantly, without adverse changes in key laboratory parameters. The correlation between the reduction of IDWG and that of serum phosphate might reflect a direct link between sodium/water and phosphate absorption.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transformer-Based Deep-Learning Model for Predicting Hemoglobin Response to Mircera® in Hemodialysis Patients.","authors":"Siwei Zhao, Yunfei Luo, Joseph Mahaffy, Subhasis Dasgupta, Armin Ahmadi, Jerome Tannenbaum, Tauhidur Rahman, Rakesh Malhotra","doi":"10.1159/000552078","DOIUrl":"10.1159/000552078","url":null,"abstract":"<p><strong>Introduction: </strong>Anemia management in hemodialysis (HD) depends on individualized erythropoiesis-stimulating agent (ESA) dosing to achieve and maintain target hemoglobin (Hgb) levels. However, predicting individual Hgb responses remains a significant challenge due to nonlinear erythropoietic dynamics and patient heterogeneity. We developed a machine learning-based approach to predict individual Hgb response to ESA therapy in HD patients.</p><p><strong>Methods: </strong>We included adult patients undergoing HD at Sanderling clinics who received intravenous (IV) ESA (Mircera®) and IV elemental iron and had ≥5 qualifying dosing events with associated post-dose Hgb measurements. Clinical, dialysis, and laboratory data were structured into an event-based dataset, where each event included pre-dose Hgb, contemporaneous Mircera® and iron doses, and follow-up Hgb 7-21 days later. Pharmacokinetically informed features, including cumulative and time-weighted Mircera® dosing, were engineered to capture delayed erythropoietic effects. A transformer-based neural network was trained using sequences of five consecutive events. Model performance was assessed using a patient-level train-test split, with mean absolute percentage error (MAPE) as the primary metric. The MAPE was calculated as the average absolute percentage error between the predicted future Hgb and the observed future Hgb. To illustrate clinical utility, we conducted simulation-based forecasting of 30-day Hgb trajectories under varying hypothetical Mircera® doses (0-200 µg) in 4 representative patients. In addition, simulation error was summarized at the cohort level across all eligible patients to assess overall forecasting performance under hypothetical dosing scenarios.</p><p><strong>Results: </strong>Among 728 HD patients, the mean age was 63 ± 14 years, with dialysis vintage 2.1 ± 1.8 years. Of these, 43% were female and 40% had diabetes. Patients received 114 ± 56 mg/week of IV iron and 149 ± 92 µg/month of IV Mircera®. Mean Hgb was 10.1 ± 0.9 g/dL, transferrin saturation (TSAT) 31 ± 10%, and ferritin level 703 ± 452 ng/mL. The transformer model predicted future Hgb with a MAPE of ∼6.0%. Simulation-based forecasting in representative patients, together with cohort-level summary of simulation error (MAPE 6.29%), demonstrated the model's ability to project individualized Hgb trajectories under varying Mircera® dosing scenarios.</p><p><strong>Conclusion: </strong>Our results showed the promising performance of a transformer-based machine learning model in predicting future Hgb levels within 6% of observed levels in HD patients being treated with Mircera® and IV iron. These findings suggest the potential for personalized ESA dosing strategies informed by sequential clinical data. Future studies should focus on refining these models and evaluating their real-world clinical utility with the goal of personalized ESA dosing to maximize on-target Hgb levels.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Bench to Bedside: Implications and Interventions for Endotoxin Exposure in Lipopolysaccharide-Induced Apoptosis and Eryptosis.","authors":"Maria Gabriela Guimarães, Claudio Ronco, Mayra Estacio, Monica Zanella, Grazia Maria Virzì","doi":"10.1159/000552431","DOIUrl":"10.1159/000552431","url":null,"abstract":"<p><strong>Background: </strong>Lipopolysaccharide (LPS), a key component of Gram-negative bacterial membranes, initiates potent inflammatory responses through both toll-like receptor 4-dependent and -independent pathways. Beyond cytokine-driven immune activation, LPS orchestrates cell death programs across diverse cell types, notably apoptosis in nucleated cells and eryptosis in erythrocytes. These processes share convergent stress signals but different mechanisms. Experimental models demonstrate that LPS, particularly in the presence of immune cells, induces erythrocyte death through oxidative injury, calcium influx, and membrane remodeling, culminating in phosphatidylserine exposure and microparticle formation, reflecting clinical patterns seen in patients with sepsis. Diagnostic tools, such as the endotoxin activity assay, enable risk stratification and enrichment for interventional trials in this population.</p><p><strong>Summary: </strong>Recent evidence from trials suggests that targeted hemoadsorption therapies may benefit select patients with LPS exposure and these pathophysiological features.</p><p><strong>Key messages: </strong>This review integrates pathophysiology, diagnostic, and therapeutic insights to highlight eryptosis as both a biomarker and mediator of inflammatory injury, offering novel mechanisms for intervention in critical illness.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-8"},"PeriodicalIF":2.2,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148337753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could Serum CA125 Aid the Clinical Assessment of Volume Status of End-Stage Kidney Disease Patients Treated by Peritoneal Dialysis Patients?","authors":"Barbara Emilia Nikitiuk, Andrew Davenport","doi":"10.1159/000553236","DOIUrl":"10.1159/000553236","url":null,"abstract":"<p><strong>Introduction: </strong>Volume overload is a major cause of technique failure, morbidity and mortality for peritoneal dialysis patients (PD). Biomarkers could potentially aid the clinical assessment of patients. Recently, Cancer antigen 125 (CA125) has been reported to predict volume status and outcomes in heart failure patients. As such we wished to evaluate CA125 in PD patients.</p><p><strong>Methods: </strong>Serum CA125 was measured in patients attending for peritoneal membrane assessment, along with bioimpedance, N-terminal probrain natriuretic peptide (NT-proBNP), who had echocardiography measurements.</p><p><strong>Result: </strong>Results from 571 PD patients, mean age 53.8 ± 10.5 years 62.4% male, 44.0% diabetic, median PD treatment 2 (2-3) months were reviewed. Serum CA125 was higher in women vs. men (25 (16-38) vs. 17 (11-29) IU/L, p < 0.05, serum CA125 was positively associated with peritoneal solute transfer rates (PSTRs) (r = 0.35), extracellular water/intracellular water (ECW/ICW) (r = 0.28), NT-proBNP (r = 0.22), and negatively with left ventricular ejection fraction (r = -0.15), all p < 0.001. Unlike other biomarkers, there was no association with residual kidney function (r = -0.05 p = 0.21). On multivariable analysis, log CA125 was associated with female gender (standardised beta [Stβ] -0.224, PSTR Stβ 0.227, comorbidity score Stβ 0.16, serum sodium Stβ -0.146 all p < 0.001, left ventricular ejection fraction Stβ -0.102, p = 0.01, and ECW/ICW ratio Stβ 0.009, p = 0.038).</p><p><strong>Conclusion: </strong>Although serum CA125 values were higher in female patients, patients with higher CA125 levels had increased markers of volume overload or reduced left ventricular ejection fraction, in keeping with previous cardiology studies, and so serial measurements may potentially aid the clinical assessment of volume status in PD patients.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148337728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility Study of a Smartphone App and Web Portal for Remote Monitoring of Chronic Kidney Disease and Peritoneal Dialysis Populations: A Mixed-Method Study.","authors":"Htay Htay, Arsh K Jain, Sheena Gow, Priyanka Arya, Joel Fernandes, Mandar Gori, Ravichandran Kaliappan, Wei Wang, Marjorie Wai Yin Foo","doi":"10.1159/000553123","DOIUrl":"10.1159/000553123","url":null,"abstract":"<p><strong>Introduction: </strong>Remote patient monitoring facilitates the management of chronic conditions like chronic kidney disease (CKD) and home-based peritoneal dialysis (PD). This study assessed the acceptance of a remote monitoring application in CKD and PD patients.</p><p><strong>Methods: </strong>It was a single-center study at Singapore General Hospital from December 2021 to February 2023, recruiting CKD and PD patients. Patients were followed up for up to 6 months. The Viva Konnect patient app allowed users to record vitals with a Bluetooth-enabled device, log medication schedule, track symptoms, log diet, and monitor PD therapy.</p><p><strong>Results: </strong>A total of 35 participants (13 CKD, 22 PD) enrolled; 8 (5 CKD, 3 PD) dropped out, leaving 27 (8 CKD, 19 PD) who completed the study. Among those who completed the study, 56% met the app acceptance criteria - defined as CKD patients logging data at least twice per week and PD patients at least once daily. Acceptance rates were 47.4% for PD and 75.0% for CKD. PD patients used the app a median of 6.7 (IQR: 1.8-16.5) times per week, spending 6.9 (IQR: 2.2-12.1) minutes per session. CKD patients used it a median of 6.2 (IQR: 2.6-6.7) times per week, with a median session time of 4.7 (IQR: 1.7-7.7) minutes. The median percentage of vitals recorded via smart companion devices was 52.9% (IQR: 26.7-82.2) for PD patients and 83.4% (IQR: 78.8-94.4) for CKD patients. Interviews identified three key themes that affected the usage: communication, convenience, and clarity.</p><p><strong>Conclusion: </strong>Overall app usage was moderate, with the CKD patient population showing better app acceptance than the PD population. To improve the usage and overall engagement, future app development should incorporate two-way communication with clinicians, a reduced burden of data recording, and better integration into established clinical workflows.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-7"},"PeriodicalIF":2.2,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Focal Segmental Glomerulosclerosis in Low- and Middle-Income Countries: Emerging Extracorporeal Therapies.","authors":"Flora R Gallegos, Kinnari Vala, Jieji Hu, Sidharth Kumar Sethi, Dean Spyres, Rama Safadi, Shay Tanna, Shahenaz Kapadia, Ali Duzova, Sampson K Antwi, Rupesh Raina","doi":"10.1159/000553218","DOIUrl":"10.1159/000553218","url":null,"abstract":"<p><strong>Introduction: </strong>Focal segmental glomerulosclerosis (FSGS) involves glomerular scarring and podocyte injury. FSGS treatment typically involves the use of corticosteroids and immunosuppressants. In patients with steroid-resistant FSGS, however, no ideal treatment exists. Extracorporeal therapies such as plasma exchange and low-density lipoprotein apheresis may be promising options for managing lipid-mediated nephrotoxicity found in patients with steroid-resistant FSGS. Unfortunately, these extracorporeal techniques are inaccessible in many low- and middle-income countries (LMICs) due to high costs and infrastructure challenges.</p><p><strong>Methods: </strong>The use of extracorporeal therapies for FSGS management was evaluated at a single center. Additionally, a literature search was conducted across multiple databases to identify studies that explored FSGS treatment modalities in LMICs. Eligibility was assessed based on discussion of viability, efficacy, and application of therapies.</p><p><strong>Results: </strong>It was found that double-filtration plasmapheresis (DFPP) and other extracorporeal therapy modalities have exhibited potential in attaining remission in patients with steroid-resistant FSGS, primarily in settings with limited resources.</p><p><strong>Discussion: </strong>The development of improvements in extracorporeal therapy, such as modified DFPP, may offer cost improvements due to reduced fluid replacement, which may lead to increased use in LMICs. Twinning programs and governmental intervention may be used to address the gaps in FSGS care in LMICs. Future efforts involve expanding access to plasmapheresis in the management of FSGS, especially in resource-limited settings.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}