Abstract
Background: Hyperlipidemia is not merely a complication but a major exacerbating factor in longstanding nephrotic syndrome (NS). Low-density lipoprotein apheresis (LDL-A) has been reported to ameliorate dyslipidemia and induce rapid remission of NS. Several clinical studies have suggested the therapeutic efficacy of LDL-A, but the level of clinical evidence is insufficient. Therefore, a multicenter prospective study, POLARIS (Prospective Observational Survey on the Long-Term Effects of LDL Apheresis on Drug-Resistant Nephrotic Syndrome), was initiated in Japan. Method: Patients with drug-resistant NS were prospectively recruited into the study and treated with LDL-A in facilities that were registered in advance. In the POLARIS study design, the clinical data are to be followed up for 2 years. In the current study, we aimed at evaluating the short-term efficacy based on the treatment outcome of LDL-A immediately after completion of treatment. Results: Along with rapid improvement of hyperlipidemia, LDL-A significantly improved proteinuria and hypoproteinemia after treatment. More than half of the patients showed remission of NS based on the urinary protein level at the completion of LDL-A. The duration of NS before the start of treatment was significantly shorter in patients who responded to LDL-A. Conclusions: An analysis of patients registered in the POLARIS study indicated that LDL-A has short-term efficacy for drug-resistant NS. Rapid relief of dyslipidemia by LDL-A may provide early remission in about half of the NS patients who are resistant to conventional medication. Completion of the POLARIS study may reveal additional long-term effects of LDL-A in these patients.
| Original language | English |
|---|---|
| Pages (from-to) | 379-386 |
| Number of pages | 8 |
| Journal | Clinical and Experimental Nephrology |
| Volume | 19 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 17-06-2015 |
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All Science Journal Classification (ASJC) codes
- Physiology
- Nephrology
- Physiology (medical)
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Immediate therapeutic efficacy of low-density lipoprotein apheresis for drug-resistant nephrotic syndrome : evidence from the short-term results from the POLARIS Study. / Muso, Eri; Mune, Masatoshi; Hirano, Tsutomu; Hattori, Motoshi; Kimura, Kenjiro; Watanabe, Tsuyoshi; Yokoyama, Hitoshi; Sato, Hiroshi; Uchida, Shunya; Wada, Takashi; Shoji, Tetsuo; Yuzawa, Yukio; Takemura, Tsukasa; Sugiyama, Satoshi; Nishizawa, Yoshiki; Ogahara, Satoru; Yorioka, Noriaki; Sakai, Soichi; Ogura, Yosuke; Yukawa, Susumu; Iino, Yasuhiko; Imai, Enyu; Matsuo, Seiichi; Saito, Takao.
In: Clinical and Experimental Nephrology, Vol. 19, No. 3, 17.06.2015, p. 379-386.Research output: Contribution to journal › Article
TY - JOUR
T1 - Immediate therapeutic efficacy of low-density lipoprotein apheresis for drug-resistant nephrotic syndrome
T2 - evidence from the short-term results from the POLARIS Study
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 - Yuzawa, Yukio
AU - Takemura, Tsukasa
AU - Sugiyama, Satoshi
AU - Nishizawa, Yoshiki
AU - Ogahara, Satoru
AU - Yorioka, Noriaki
AU - Sakai, Soichi
AU - Ogura, Yosuke
AU - Yukawa, Susumu
AU - Iino, Yasuhiko
AU - Imai, Enyu
AU - Matsuo, Seiichi
AU - Saito, Takao
PY - 2015/6/17
Y1 - 2015/6/17
N2 - Background: Hyperlipidemia is not merely a complication but a major exacerbating factor in longstanding nephrotic syndrome (NS). Low-density lipoprotein apheresis (LDL-A) has been reported to ameliorate dyslipidemia and induce rapid remission of NS. Several clinical studies have suggested the therapeutic efficacy of LDL-A, but the level of clinical evidence is insufficient. Therefore, a multicenter prospective study, POLARIS (Prospective Observational Survey on the Long-Term Effects of LDL Apheresis on Drug-Resistant Nephrotic Syndrome), was initiated in Japan. Method: Patients with drug-resistant NS were prospectively recruited into the study and treated with LDL-A in facilities that were registered in advance. In the POLARIS study design, the clinical data are to be followed up for 2 years. In the current study, we aimed at evaluating the short-term efficacy based on the treatment outcome of LDL-A immediately after completion of treatment. Results: Along with rapid improvement of hyperlipidemia, LDL-A significantly improved proteinuria and hypoproteinemia after treatment. More than half of the patients showed remission of NS based on the urinary protein level at the completion of LDL-A. The duration of NS before the start of treatment was significantly shorter in patients who responded to LDL-A. Conclusions: An analysis of patients registered in the POLARIS study indicated that LDL-A has short-term efficacy for drug-resistant NS. Rapid relief of dyslipidemia by LDL-A may provide early remission in about half of the NS patients who are resistant to conventional medication. Completion of the POLARIS study may reveal additional long-term effects of LDL-A in these patients.
AB - Background: Hyperlipidemia is not merely a complication but a major exacerbating factor in longstanding nephrotic syndrome (NS). Low-density lipoprotein apheresis (LDL-A) has been reported to ameliorate dyslipidemia and induce rapid remission of NS. Several clinical studies have suggested the therapeutic efficacy of LDL-A, but the level of clinical evidence is insufficient. Therefore, a multicenter prospective study, POLARIS (Prospective Observational Survey on the Long-Term Effects of LDL Apheresis on Drug-Resistant Nephrotic Syndrome), was initiated in Japan. Method: Patients with drug-resistant NS were prospectively recruited into the study and treated with LDL-A in facilities that were registered in advance. In the POLARIS study design, the clinical data are to be followed up for 2 years. In the current study, we aimed at evaluating the short-term efficacy based on the treatment outcome of LDL-A immediately after completion of treatment. Results: Along with rapid improvement of hyperlipidemia, LDL-A significantly improved proteinuria and hypoproteinemia after treatment. More than half of the patients showed remission of NS based on the urinary protein level at the completion of LDL-A. The duration of NS before the start of treatment was significantly shorter in patients who responded to LDL-A. Conclusions: An analysis of patients registered in the POLARIS study indicated that LDL-A has short-term efficacy for drug-resistant NS. Rapid relief of dyslipidemia by LDL-A may provide early remission in about half of the NS patients who are resistant to conventional medication. Completion of the POLARIS study may reveal additional long-term effects of LDL-A in these patients.
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UR - http://www.scopus.com/inward/citedby.url?scp=84931007441&partnerID=8YFLogxK
U2 - 10.1007/s10157-014-0996-8
DO - 10.1007/s10157-014-0996-8
M3 - Article
C2 - 24934117
AN - SCOPUS:84931007441
VL - 19
SP - 379
EP - 386
JO - Clinical and Experimental Nephrology
JF - Clinical and Experimental Nephrology
SN - 1342-1751
IS - 3
ER -