Significantly rapid relief from steroid-resistant nephrotic syndrome by LDL apheresis compared with steroid monotherapy.
Rapid amelioration of hypercholesterolemia by LDL apheresis (LDL-A) was performed for long-standing nephrotic syndrome (NS) with hyperlipidemia due to focal segmental glomerulosclerosis (FGS) and the clinical data and prognosis were compared between LDL-A-treated and nontreated groups. Seventeen steroid-resistant NS patients treated with LDL-A (LDL-A group) and 10 NS patients treated with steroids only (steroid-monotherapy (SM) group) were compared. Serum cholesterol and phospholipid levels were significantly lowered only in the LDL-A group (p < 0.01, respectively). The LDL-A group showed a significant decrease of urinary protein (UP, p < 0.01) and increase of serum albumin (p < 0.05). Average time needed to achieve a decrease of UP to less than nephrotic range (< 3.5 g/day) was significantly shorter in the LDL-A group than in the SM group (p < 0.01). Although this is not a prospective study, it is highly expected that a rapid improvement of hypercholesterolemia by LDL-A in steroid-resistant NS will provide more rapid relief from NS than steroid therapy alone.
Muso
E
E
Kyoto University Graduate School of Medicine, Kyoto, Japan. muso@kuhp.kyoto-u.ac.jp
Mune
M
M
Fujii
Y
Y
Imai
E
E
Ueda
N
N
Hatta
K
K
Imada
A
A
Takemura
T
T
Miki
S
S
Kuwahara
T
T
Takamitsu
Y
Y
Tsubakihara
Y
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001781:Blood Component Removal; D001798:Blood Proteins / Q000032:analysis; D001806:Blood Urea Nitrogen; D008078:Cholesterol, LDL / Q000097:blood*; D003404:Creatinine / Q000097:blood; D004351:Drug Resistance; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000188:drug therapy*; D006801:Humans; D006949:Hyperlipidemias / Q000628:therapy; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D011239:Prednisolone / Q000627:therapeutic use*; D011507:Proteinuria / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D001798:Blood Proteins; D008078:Cholesterol, LDL; D011239:Prednisolone; D003404:Creatinine