{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:35:10Z","timestamp":1760060110400,"version":"build-2065373602"},"reference-count":25,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["IK6BX005691"],"award-info":[{"award-number":["IK6BX005691"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background\/Objectives: Thrombotic thrombocytopenic purpura (TTP) is a microangiopathic hemolytic anemia exhibiting 90% mortality without prompt treatment. The aim of this study was to investigate the association of therapeutic plasma exchange (TPE)-treated TTP in end-stage renal disease (ESRD) patients with mortality, demographics, and clinical comorbidities. We queried the United States Renal Data System for ESRD patients starting dialysis between 1 January 2005 and 31 December 2018, using International Classification of Diseases (ICD)-9 and ICD-10 codes for thrombotic microangiopathy, with a TPE procedure code entered within 7 days. Methods: Cox proportional hazards models were used to assess mortality, adjusting for demographic and clinical factors. Results: Among 1,155,136 patients, increased age [adjusted odds ratio (OR) = 0.96, 95% confidence interval (CI): 0.94\u20130.96]; black race (OR = 0.67, CI: 0.51\u20130.89); and Hispanic ethnicity (OR = 0.43, CI: 0.28\u20130.66) were associated with a lower risk of TPE-treated TTP diagnosis, whereas female sex (OR = 1.59, CI: 1.25\u20132.02) and tobacco use (OR = 2.08, CI: 1.58\u20132.75) had a higher risk. A claim for TPE-treated TTP carried a lower risk of death (adjusted hazard ratio = 0.024, CI: 0.021\u20130.028). Female sex, black race, Hispanic ethnicity, and hypothyroidism were also associated with decreased all-cause mortality. Conclusions: These findings suggest that ESRD patients with TPE-treated TTP are significantly protected from mortality compared with ESRD patients without this diagnosis.<\/jats:p>","DOI":"10.3390\/diseases13080247","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T14:23:19Z","timestamp":1754403799000},"page":"247","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Therapeutic Plasma Exchange-Treated Thrombotic Thrombocytopenic Purpura with Improved Mortality Outcome in End-Stage Renal Disease"],"prefix":"10.3390","volume":"13","author":[{"given":"Brenna S.","family":"Kincaid","sequence":"first","affiliation":[{"name":"Medical College of Georgia, Augusta University, Augusta, GA 30912, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiana","family":"Kim","sequence":"additional","affiliation":[{"name":"Medical College of Georgia, Augusta University, Augusta, GA 30912, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4066-4541","authenticated-orcid":false,"given":"Jennifer L.","family":"Waller","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7871-755X","authenticated-orcid":false,"given":"Stephanie L.","family":"Baer","sequence":"additional","affiliation":[{"name":"Medical College of Georgia, Augusta University, Augusta, GA 30912, USA"},{"name":"VA Augusta Health Care System, Augusta, GA 30904, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3146-162X","authenticated-orcid":false,"given":"Wendy B.","family":"Bollag","sequence":"additional","affiliation":[{"name":"VA Augusta Health Care System, Augusta, GA 30904, USA"},{"name":"Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4963-6619","authenticated-orcid":false,"given":"Roni J.","family":"Bollag","sequence":"additional","affiliation":[{"name":"Department of Pathology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Sukumar, S., L\u00e4mmle, B., and Cataland, S.R. 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