Effect of low-density lipoprotein apheresis on urinary protein and podocyte excretion in patients with nephrotic syndrome due to diabetic nephropathy.
BACKGROUND
The aim of the present study is to determine whether low-density lipoprotein (LDL) apheresis affects proteinuria and urinary podocyte excretion in patients with type 2 diabetes and nephrotic syndrome.


METHODS
LDL apheresis was performed on patients with diabetes with long-standing nephrotic syndrome, and urinary protein level and number of urinary podocytes were compared between these patients (5 men, 3 women; mean age, 54.6 years) and 10 nephrotic patients with diabetes not treated with LDL apheresis (6 men, 4 women; mean age, 56.5 years).


RESULTS
LDL apheresis reduced total cholesterol (P < 0.001), LDL cholesterol ( P < 0.001), lipoprotein(a) (P < 0.001), creatinine (P < 0.05), and blood urea nitrogen (P < 0.05) levels and increased creatinine clearance (P < 0.05). The LDL apheresis group showed a significant decrease in urinary protein excretion (from 10.8 +/- 3.2 to 1.8 +/- 1.1 g/d; P < 0.001) and number of urinary podocytes (from 4.8 +/- 2.2 to 0.9 +/- 0.4 cells/mL; P < 0.01).


CONCLUSIONS
These data suggest that LDL apheresis effectively reduces proteinuria and podocyte excretion, ameliorating renal dysfunction in patients with nephrotic syndrome caused by diabetic nephropathy.
Nakamura
Tsukasa
T
Department of Medicine, Shinmatsudo Central General Hospital, Chiba, Japan.
Kawagoe
Yasuhiro
Y
Ogawa
Hiroshi
H
Ueda
Yoshihiko
Y
Hara
Masanori
M
Shimada
Noriaki
N
Ebihara
Isao
I
Koide
Hikaru
H
D000328:Adult; D000368:Aged; D001781:Blood Component Removal / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000473:pathology / Q000652:urine; D003928:Diabetic Nephropathies / Q000097:blood / Q000150:complications* / Q000473:pathology / Q000652:urine; D005260:Female; D006801:Humans; D007668:Kidney / Q000378:metabolism* / Q000473:pathology*; D008077:Lipoproteins, LDL / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000097:blood / Q000209:etiology* / Q000473:pathology / Q000652:urine; D011507:Proteinuria / Q000628:therapy*
D008077:Lipoproteins, LDL