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

研究成果: Article

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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.

元の言語English
ページ(範囲)58-66
ページ数9
ジャーナルNephron Extra
5
発行部数2
DOI
出版物ステータスPublished - 01-01-2015

All Science Journal Classification (ASJC) codes

  • Nephrology

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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., ... 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