Extracorporeal photochemotherapy for the treatment of glomerulopathies with associated nephrotic syndrome.
BACKGROUND
Patients with glomerulopathies associated with nephrotic syndrome have few effective treatment options. Here we report on the use of extracorporeal photochemotherapy (ECP) in 6 patients in whom glomerulopathy failed to respond to pharmacologic therapy. ECP is a promising immunomodulatory therapy associated with few side effects, that has been successfully used in the treatment of other immune-mediated conditions such as solid organ transplant rejection and graft-versus-host disease.


METHODS
In this study, patients underwent 12 months of ECP. In all patients, progressive improvement in proteinuria was noted during the follow-up period, and total cholesterol and triglyceride levels also returned to near-normal values.


RESULTS
In the 4 patients who had adequate renal function at study initiation, improvement of renal function was observed, as indicated by improved glomerular filtration rates (GFRs) and decreased proteinuria to creatininuria (Pru/Cru) ratios. In contrast, renal function progressively worsened in the 2 patients with inadequate renal function at study initiation.


CONCLUSIONS
The results suggest that ECP is a feasible treatment for patients with glomerulopathies associated with nephrotic syndrome who have adequate baseline renal function. Additional clinical evaluation will have to be performed to better define the patient population in which ECP is most effective.
Russo
Gaspare Elios
GE
Department of Nephrology, University of Rome La Sapienza, Rome, Italy.
Cavallini
Marco
M
Centi
Alessia
A
Baliva
Giannandrea
G
Carraro
Michele
M
Pugliese
Francesco
F
D002784:Cholesterol / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology; D005921:Glomerulonephritis / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D009404:Nephrotic Syndrome / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D017893:Photopheresis / Q000379:methods*; D011507:Proteinuria / Q000097:blood; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D014280:Triglycerides; D002784:Cholesterol