Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 58-66 |
| Number of pages | 9 |
| Journal | Nephron Extra |
| Volume | 5 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 01-01-2015 |
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All Science Journal Classification (ASJC) codes
- Nephrology
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A prospective observational survey on the long-term effect of ldl apheresis on drug-resistant nephrotic syndrome. / Muso, Eri; Mune, Masatoshi; Hirano, Tsutomu; Hattori, Motoshi; Kimura, Kenjiro; Watanabe, Tsuyoshi; Yokoyama, Hitoshi; Sato, Hiroshi; Uchida, Shunya; Wada, Takashi; Shoji, Tetsuo; Takemura, Tsukasa; Yuzawa, Yukio; Ogahara, Satoru; Sugiyama, Satoshi; Iino, Yasuhiko; Sakai, Soichi; Ogura, Yousuke; Yukawa, Susumu; Nishizawa, Yoshiki; Yorioka, Noriaki; Imai, Enyu; Matsuo, Seiichi; Saito, Takao.
In: Nephron Extra, Vol. 5, No. 2, 01.01.2015, p. 58-66.Research output: Contribution to journal › Article
TY - JOUR
T1 - A prospective observational survey on the long-term effect of ldl apheresis on drug-resistant nephrotic syndrome
AU - Muso, Eri
AU - Mune, Masatoshi
AU - Hirano, Tsutomu
AU - Hattori, Motoshi
AU - Kimura, Kenjiro
AU - Watanabe, Tsuyoshi
AU - Yokoyama, Hitoshi
AU - Sato, Hiroshi
AU - Uchida, Shunya
AU - Wada, Takashi
AU - Shoji, Tetsuo
AU - Takemura, Tsukasa
AU - Yuzawa, Yukio
AU - Ogahara, Satoru
AU - Sugiyama, Satoshi
AU - Iino, Yasuhiko
AU - Sakai, Soichi
AU - Ogura, Yousuke
AU - Yukawa, Susumu
AU - Nishizawa, Yoshiki
AU - Yorioka, Noriaki
AU - Imai, Enyu
AU - Matsuo, Seiichi
AU - Saito, Takao
PY - 2015/1/1
Y1 - 2015/1/1
N2 - 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.
AB - 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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U2 - 10.1159/000437338
DO - 10.1159/000437338
M3 - Article
VL - 5
SP - 58
EP - 66
JO - Nephron Extra
JF - Nephron Extra
SN - 1664-5529
IS - 2
ER -