Abstract: Objective To investigate the clinical efficacy of plasma exchange (PE) and hemodialysis (HD) in children with lupus nephritis. Methods We retrospectively analyzed 12 children with lupus nephritis who were admitted to the Department of Rheumatology and Immunology of our hospital for plasmapheresis from January 1, 2022 to August 31, 2024. The treatment is formulated according to the children's condition, gender, height, weight, hematocrit and other indicators. The levels of ANA, Anti-dsDNA antibody, hemoglobin, white blood cells, platelets, total protein, albumin, globulin, white globulin ratio and coagulation function were measured before and after PE. The changes in creatinine and urea nitrogen levels at discharge and during replacement were detected. Results The average number of plasma exchanges in 12 children was about 3, and the average total amount of replacement fluid was about 1 600 (1 200~2 200) mL, which was about 1.3±0.23 total plasma volume (TPV), and there were no statistically significant differences in Hb, PLT, PT, PTA, INR, ALB, Cr, and BUN before and after PE (P>0.05), WBC, APTT, FIB, TP, GLB, A/G ware statistically significant (P<0.05). At discharge, the creatinine of the children decreased to about 100 μmol/L, and the positive intensity of urine protein was also weakened. Conclusion PE combined with HDF can effectively improve renal function in children with lupus nephritis.

Key words: Child, Plasma exchange, Hemodiafiltration, Systemic lupus erythematosus nephritis