@article{6318e76e058541328bb0e31b99ade167,
title = "A prospective observational survey on the long-term effect of ldl apheresis on drug-resistant nephrotic syndrome",
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.",
author = "Eri Muso and Masatoshi Mune and Tsutomu Hirano and Motoshi Hattori and Kenjiro Kimura and Tsuyoshi Watanabe and Hitoshi Yokoyama and Hiroshi Sato and Shunya Uchida and Takashi Wada and Tetsuo Shoji and Tsukasa Takemura and Yukio Yuzawa and Satoru Ogahara and Satoshi Sugiyama and Yasuhiko Iino and Soichi Sakai and Yousuke Ogura and Susumu Yukawa and Yoshiki Nishizawa and Noriaki Yorioka and Enyu Imai and Seiichi Matsuo and Takao Saito",
note = "Funding Information: This study was conducted under a grant from the Kidney Foundation, Japan, which was financially supported by Kaneka Corporation (Osaka, Japan). Funding Information: This study was supported by the Research and Surveillance Group for Progressive Renal Impairment of the ?inistry of Health, Labor and Welfare of Japan. The authors express their appreciation to all the investigators who reported clinical data in this study, including Atsushi Oyama (Nishi-Kobe ?edical Center), Noriaki Henmi (Fukaya Red Cross Hospital), Noriko ?ori (Shizuoka General Hospital), Osamu Nishi (Nishi Clinic), Yasukiyo ?ori (Kyoto Prefectural University of ?edicine), ?egumu Fukunaga (Toyonaka ?unicipal Hospital), ?asahiko ?iyamoto (Osaka Red Cross Hospital), Kenji Arizono (Kumamoto Chuo Hospital), Takako Suzuki (?oriyama Rehabilitation Hospital), Kazuhiko Hora (Hokushin General Hospital), Hiroshi ?akino (Okayama University), Hideyasu Kiyomoto (Kagawa University ?edical School), Yutaka Ando (Osaka ?inami ?edical Center), Yoshiharu Tsubakihara (Osaka General ?edical Center), Kosuke Ota (Okayama ?edical Center), ?asamichi Fukuda (Iwakuni ?edical Center Hospital), Yukiko Abe (Shin-Oura Hospital), ?itsuhiro Yoneda (Fuke Chiba Hospital), Hiroshi Ohtani (Akita Kumiai General Hospital), Tokuichiro Sugimoto (?itsui ?emorial Hospital), Shizunori Ichida (Japanese Red Cross Nagoya Daiichi Hospital), Kentaro Wada (Nippon Kokan Fukuyama Hospital), Rhosuke Yoshihara (Konan Kakogawa Hospital), Shoichi Fujimoto (University of ?iyazaki), ?orihiro Kondo (Rakuwa-kai Otowa Hospital), Takeshi Nakanishi (Hyogo College of ?edicine), Kazuhiko Tsuruya (Kyusyu University), Fumiki Tanigawa (Shimonoseki Kosei Hospital), ?asami Hashimoto (Onomichi General Hospital), Akiko Nakamura (Saga Prefectural Hospital Koseikan), Soshi Yorifuji (Osaka Saiseikai Nakatsu Hospital), and Tamaki Sasaki (Kawasaki ?edical School). Publisher Copyright: {\textcopyright} 2015 The Author(s).",
year = "2015",
doi = "10.1159/000437338",
language = "English",
volume = "5",
pages = "58--66",
journal = "Nephron Extra",
issn = "1664-5529",
publisher = "S. Karger AG",
number = "2",
}