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Titolo:
Low density lipoprotein apheresis therapy for steroid-resistant nephrotic syndrome
Autore:
Muso, E; Mune, M; Fujii, Y; Imai, E; Ueda, N; Hatta, K; Imada, A; Miki, S; Kuwahara, T; Takamitsu, Y; Takemura, T; Tsubakihara, Y;
Indirizzi:
Kyotoanniv, Grad Sch Med, Dept Cardiovasc Med, Sakyo Ku, Kyoto 6068397, Jap Kyoto Univ Kyoto Japan 6068397 diovasc Med, Sakyo Ku, Kyoto 6068397, Jap Wakayama Med Coll, Wakayama 640, Japan Wakayama Med Coll Wakayama Japan 640 ayama Med Coll, Wakayama 640, Japan Nara Med Univ, Nara, Japan Nara Med Univ Nara JapanNara Med Univ, Nara, Japan Tenri Hosp, Nara, Japan Tenri Hosp Nara JapanTenri Hosp, Nara, Japan Osaka Univ, Fac Med, Suita, Osaka 565, Japan Osaka Univ Suita Osaka Japan565 a Univ, Fac Med, Suita, Osaka 565, Japan Kinki Univ, Sch Med, Higashiosaka, Osaka 577, Japan Kinki Univ Higashiosaka Osaka Japan 577 d, Higashiosaka, Osaka 577, Japan Osaka Saiseikai Nakatsu Hosp, Osaka, Japan Osaka Saiseikai Nakatsu Hosp Osaka Japan kai Nakatsu Hosp, Osaka, Japan Osaka Prefecture Hosp, Osaka, Japan Osaka Prefecture Hosp Osaka JapanOsaka Prefecture Hosp, Osaka, Japan Hyogo Coll Med, Nishinomiya, Hyogo, Japan Hyogo Coll Med Nishinomiya Hyogo Japan ll Med, Nishinomiya, Hyogo, Japan Takasago City Hosp, Takasago, Hyogo, Japan Takasago City Hosp Takasago Hyogo Japan ity Hosp, Takasago, Hyogo, Japan
Titolo Testata:
KIDNEY INTERNATIONAL
, volume: 56, anno: 1999, supplemento:, 71
pagine: S122 - S125
SICI:
0085-2538(199907)56:<S122:LDLATF>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
FOCAL SEGMENTAL GLOMERULOSCLEROSIS;
Keywords:
thromboxane B-2; progressive renal disease; tubulointerstitial injury; focal segmental glomerulosclerosis; minimal change nephrotic syndrome;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
13
Recensione:
Indirizzi per estratti:
Indirizzo: Muso, E Kyototoniv, Grad Sch Med, Dept Cardiovasc Med, Sakyo Ku, 54 Kawara-cho, Kyo Kyoto Univ 54 Kawara-cho Kyoto Japan 6068397 , 54 Kawara-cho, Kyo
Citazione:
E. Muso et al., "Low density lipoprotein apheresis therapy for steroid-resistant nephrotic syndrome", KIDNEY INT, 56, 1999, pp. S122-S125

Abstract

Background. The pathogenic role of hyperlipidemia in longstanding nephrotic syndrome (NS) is known to be responsible for both the progression of glomerulosclerosis and tubulointerstitial injury, especially in focal segmentalglomerulosclerosis (FGS). Methods. Aggressive lipid lowering treatment by low density lipoprotein (LDL) apheresis (LDL-A) using a dextran sulfate cellulose column to treat patients with steroid-resistant or frequently recurrent severe NS was performed first without fixing the protocol in eight patients with FGS and one withminimal change nephrotic syndrome (MCNS). The period of NS before LDL-X, number and average intervals of LDL-A until the end of the therapy, and the prognosis were investigated. Next, a multicenter study with a fixed protocol of LDL-A treatment was designed in combination with steroid therapy for treatment twice a week for three weeks and weekly for six weeks. and was performed in 17 patients with FGS. The effects on the state of NS in addition to the change of urinary eicosanoid metabolites and remission rates were evaluated. Results. In the preliminary study, along with a rapid improvement of hyperlipidemia, a high incidence of remission was achieved by LDL-A performed atrelatively short intervals. In the multicenter study with a fixed protocol. there was a significant decrease of urinary protein (P < 0.001) and increase of serum albumin (P < 0.02) as well as a decrease of thromboxane B-2 (TxB(2)) excretion (P < 0.05) after the treatment. Urinary excretion of TXB2 was significantly reduced after LDL-A (P < 0.05). The rate of entering intocomplete or incomplete remission was 71% with a relatively short duration of nephrotic-range proteinuria using the LDL-A therapy in comparison with steroid therapy alone. Conclusion. The rapid improvement of hypercholesterolemia with LDL-A treatment may provide a new approach for a high rate of improvement in the degree of NS in steroid-resistant NS of FGS and MCNS.

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Documento generato il 26/01/20 alle ore 10:26:13