Several renal diseases, especialy those with immunologic bases or those due to putative toxic mediators do not respond well to the usual medical modalitis. These diseases are usually serious and may lead to different morbidities and mortalities. Plasmapheresis may serve as a supplemental therapy in many of these diseases and can lead to better therapeutic response as in focal segmental glomerulosclerosis (post transplant), rapidly progressive glomerulonephritis, IgA nephritis and HSP nephritis.