Plasmapheresis, Infection, and Renal Disease-Reply

In Reply.— We appreciate the letter by Dr Cohen and look forward to a full report of his findings. The high incidence of major infectious complications in Dr Cohen's series supports the conclusions of our study that plasmapheresis in renal patients predisposes to serious infections. The infection rate in our patients (63%) and in previous publications (26%) supports this association. The lack of correlation between infection and duration of plasmapheresis in Dr Cohen's series, which was also noted in our patients, does not obviate this association. In contrast, infection developed in only two of 21 renal patients in our control group (not treated with plasmapheresis). Although the findings of these studies await confirmation in controlled trials, the apparent relation between plasmapheresis for renal disease and serious infection suggests that this therapy must be used with great caution.