A prospective observational survey on the long-term effect of ldl apheresis on drug-resistant nephrotic syndrome

Eri Muso, Masatoshi Mune, Tsutomu Hirano, Motoshi Hattori, Kenjiro Kimura, Tsuyoshi Watanabe, Hitoshi Yokoyama, Hiroshi Sato, Shunya Uchida, Takashi Wada, Tetsuo Shoji, Tsukasa Takemura, Yukio Yuzawa, Satoru Ogahara, Satoshi Sugiyama, Yasuhiko Iino, Soichi Sakai, Yousuke Ogura, Susumu Yukawa, Yoshiki NishizawaNoriaki Yorioka, Enyu Imai, Seiichi Matsuo, Takao Saito

Research output: Contribution to journalArticle

9 Citations (Scopus)

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 languageEnglish
Pages (from-to)58-66
Number of pages9
JournalNephron Extra
Volume5
Issue number2
DOIs
Publication statusPublished - 01-01-2015

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Blood Component Removal
Nephrotic Syndrome
Pharmaceutical Preparations
Proteins
Surveys and Questionnaires
Complementary Therapies
oxidized low density lipoprotein
Hyperlipidemias
Serum Albumin
LDL Cholesterol
Multicenter Studies
Creatinine
Therapeutics
Prospective Studies
Serum

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Muso, E., Mune, M., Hirano, T., Hattori, M., Kimura, K., Watanabe, T., ... Saito, T. (2015). A prospective observational survey on the long-term effect of ldl apheresis on drug-resistant nephrotic syndrome. Nephron Extra, 5(2), 58-66. https://doi.org/10.1159/000437338
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. / A prospective observational survey on the long-term effect of ldl apheresis on drug-resistant nephrotic syndrome. In: Nephron Extra. 2015 ; Vol. 5, No. 2. pp. 58-66.
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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",
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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 2015, 'A prospective observational survey on the long-term effect of ldl apheresis on drug-resistant nephrotic syndrome', Nephron Extra, vol. 5, no. 2, pp. 58-66. https://doi.org/10.1159/000437338

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 journalArticle

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

AN - SCOPUS:85020266651

VL - 5

SP - 58

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JF - Nephron Extra

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