Apheresis is not the same as apheresis.....
Environmental apheresis was first researched, published and applied by INUS.
16 years ago, when we started working on the use of double membrane filtration apheresis in environmental diseases, we were the pioneers in the field. We have spent many years of researching and testing to determine the right application with the right filter and the perfect device. Altogether, our medical director Dr. R. Straube, nephrologist and specialist in internal and environmental medicine, has performed more than 30,000 apheresis treatments, 12,000 of which in our clinic.
For 3 years, we have been working on a study of our own with more than 1,000 patients and 178,000 individual markers to determine in which cases and using which filter double membrane filtration is helpful and successful.
By now, word has spread about our successes. Unfortunately, this has also produced negative consequences. There are physicians who neither have completed an appropriate training nor have the experience to perform a high-quality apheresis. Nevertheless, they offer the treatment, mostly for financial reasons. Since the term “apheresis” simply means “separate” or “remove”, it can be applied to many different procedures.
Types of apheresis:
Plasmapheresis as plasma phlebotomy. This procedure separates the plasma and the red components of the blood. Then, a part of the plasma is disposed of. The resulting formation of new plasma merely dilutes the concentration of toxins in the plasma. The effect of this procedure is limited. No filter is required, only a separator, which is available at very favorable prices.
Unselective plasmapheresis. This procedure also separates the plasma from the blood by means of a separator. Then, however, the plasma is completely substituted. Attention! Information must be provided on possible side effects and the source of the plasma substitute.
Selective plasmapheresis. This procedure separates the pathogenic substances or proteins from the plasma by filtration or adsorption. Then, the cleansed plasma is returned to the patient. There are different filters, e.g. for
• lipid apheresis, with lipid filter for the removal of cholesterol, LDL, lipoprotein(a)
• reopheresis in case of macular degeneration (eye disease)
• IgE and IgG apheresis in case of allergies and atopies
The effect of the treatment is determined by the filter used in cooperation with the technical part. There are very low priced filters and very expensive ones, depending on what is to be filtered out.
In environmental therapy, double membrane filtration apheresis must be used as environmental apheresis with special filters that also filter out environmental toxins.
Please refer to the following points to check the qualification of your physician and the quality of the applied procedure.
• According to the guidelines of the German Association of SHI Physicians / Federal Joint Committee, a physician must be a specialist in either cardiology, nephrology, rheumatology, pediatrics and hebiatrics with sub-specialty qualification in nephrology, or internal medicine. Please ask for your physician‘s qualification.
• If a physician is a specialist in another field, they are required to have the relevant experience. They are deemed as experienced if they can furnish certain proofs (see guidelines of the Association of SHI Physicians cited below)
• According to the European Association of Nephrologists, they should have completed 150 hours of apheresis training in 4 different procedures in a center that is qualified to conduct such training.
Please ask the following questions:
• Which specialty training has your therapist undergone?
• If he/she does not have any of the qualifications stipulated by the German Association of SHI Physicians / Federal Joint Committee cited above, ask them to furnish proof of their qualification/experience. They must be in possession of a training or qualification certificate.
• Ask how many apheresis treatments he/she has already performed, and over which period of time.
• Have them confirm which procedure they apply and which filter they use. If you have doubts, ask for the device name and the filter designation, and contact our office. We will gladly do some research for you.
• Ask for a proof of the presence of environmental toxins in the eluate (filtered out plasma). If he/she is an experienced therapist, they will have laboratory proof that these substances have been filtered out.
• Make sure that emergency equipment (defibrillator, O2 Equipment, etc.) is present.
• Make sure that a patient monitoring is connected during the apheresis.
In general, you can recognize qualified practices by their orientation/specialization. If the list of services offered by a practice looks like a “supermarket of specialist services” covering a large number of specialist fields, then proof it.
INUS Medical Center AG
Guidelines for the Methods of Medical Care Provision by SHI Physicians (Richtlinie Methoden vertragsärztliche Versorgung), in the version of 17 January 2006, published in the German Federal Law Gazette 2006, No. 48 (p. 1523), entered into force on 1st April 2006, last amended on 16 June 2016, published in the German Federal Law Gazette on 7 September 2016 (Banz AT 07.09.2016 B3), entered into force on 8 September 2016
• Authorization for Performing and Billing
• The performing and billing of apheresis treatments in the context of medical care provision by SHI physicians is only permitted after authorization has been granted.
Authorization is to be granted to physicians who are entitled to bear the title of
• “Specialist in Internal Medicine and Nephrology”, “Specialist in Internal Medicine” with sub-specialty qualification in “Nephrology”, or “Specialist in Pediatrics and Hebiatrics” with additional qualification in “Pediatric Nephrology”.
Physicians who are specialists in other fields for which the specialist training regulations of the German Medical Association envisage the performing of therapeutic aphereses, are to be granted an authorization if they can furnish proof that they have sufficient experience
a) in general in the performing of one of the therapeutic aphereses cited in §3, and in the treatment of typical apheresis-associated complications, and
b) in specific indications, e.g. Lp(a), rheumatism and arthritis, immune diseases
The authorization is to be limited to the indications for which the indication-specific requirements according to part b) are met. The above-mentioned specialist, sub-specialty and additional qualifications conform to the specialist training regulations of the German Medical Association, comprising also those physicians who bear a corresponding title according to previous regulations.
The following is recognized as “experience”:
• 1000 apheresis treatments in a specialist center, or
• 24 months of full-time work in an apheresis center
According to the European Association of Nephrologists: 150 hours of apheresis training on at least 4 different systems in a nephrological practice.
Welcome to INUS!
Therapeutic INUSpheresis® (TI), an innovative component of our day hospital's concept, is a special form of high-tech plasma cleaning and immunomodulation used in the treatment of chronic and acute diseases of the metabolism and the immune system.
Plasma cleaning, also called INUSpheresis®, helps the body eliminate harmful proteins and metabolites (e.g. cholesterol and many others) or toxic substances (so-called paraproteins, tumor-associated proteins, circulating immune complexes, complex infectious toxins, pathoproteins, and haptens). In doing so, it interrupts the inflammatory cascade and restores the dysregulated metabolism or immune system to its natural balance (a so-called metabolic modulation / immunomodulation).
INUSpheresis® does not involve plasma exchange nor does it lead to a significant loss of electrolytes or immune bodies. It is a gentle method which is very well tolerated and imposes little stress on the organism.
It is applied in the treatment of environmental diseases, rheumatic diseases, lipid disorders, chronic inflammations, post-infectious disease syndromes (e.g. in case of Lyme disease), and autoimmune diseases.