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2015 ; 5
(2
): 58-66
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
A Prospective Observational Survey on the Long-Term Effect of LDL Apheresis on
Drug-Resistant Nephrotic Syndrome
#MMPMID26557843
Muso E
; Mune M
; Hirano T
; Hattori M
; Kimura K
; Watanabe T
; Yokoyama H
; Sato H
; Uchida S
; Wada T
; Shoji T
; Takemura T
; Yuzawa Y
; Ogahara S
; Sugiyama S
; Iino Y
; Sakai S
; Ogura Y
; Yukawa S
; Nishizawa Y
; Yorioka N
; Imai E
; Matsuo S
; Saito T
Nephron Extra
2015[May]; 5
(2
): 58-66
PMID26557843
show ga
BACKGROUND/AIMS: LDL apheresis (LDL-A) is used for drug-resistant nephrotic
syndrome (NS) as an alternative therapy to induce remission by improvement of
hyperlipidemia. Several clinical studies have suggested the efficacy of LDL-A for
refractory NS, but the level of evidence remains insufficient. A multicenter
prospective study, POLARIS (Prospective Observational Survey on the Long-Term
Effects of LDL Apheresis on Drug-Resistant Nephrotic Syndrome), was conducted to
evaluate its clinical efficacy with high-level evidence. METHODS: Patients with
NS who showed resistance to primary medication for at least 4 weeks were
prospectively recruited to the study and treated with LDL-A. The long-term
outcome was evaluated based on the rate of remission of NS 2 years after
treatment. Factors affecting the outcome were also examined. RESULTS: A total of
58 refractory NS patients from 40 facilities were recruited and enrolled as
subjects of the POLARIS study. Of the 44 subjects followed for 2 years, 21
(47.7%) showed remission of NS based on a urinary protein (UP) level <1.0 g/day.
The UP level immediately after LDL-A and the rates of improvement of UP, serum
albumin, serum creatinine, eGFR, and total and LDL cholesterol after the
treatment session significantly affected the outcome. CONCLUSIONS: Almost half of
the cases of drug-resistant NS showed remission 2 years after LDL-A. Improvement
of nephrotic parameters at termination of the LDL-A treatment was a predictor of
a favorable outcome.
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