Apheresis Therapy for Steroid-Resistant Idiopathic Nephrotic Syndrome: Report on a Case Series

Hamza Naciri Bennani; Thomas Jouve; Johan Noble; Lionel Rostaing; Paolo Malvezzi; Rachel Tetaz

doi:10.1155/2019/7304786

Apheresis Therapy for Steroid-Resistant Idiopathic Nephrotic Syndrome: Report on a Case Series

Case Rep Nephrol. 2019 Oct 9:2019:7304786. doi: 10.1155/2019/7304786. eCollection 2019.

Authors

Hamza Naciri Bennani¹, Thomas Jouve^{1

2}, Johan Noble^{1

2}, Lionel Rostaing^{1

2}, Paolo Malvezzi¹, Rachel Tetaz¹

Affiliations

¹ Service de Néphrologie, Hémodialyse, Aphérèses et Transplantation Rénale, CHU Grenoble-Alpes, Grenoble, France.
² Université Grenoble Alpes, Grenoble, France.

Abstract

Idiopathic nephrotic syndrome (INS) represents 15%-30% of adulthood glomerulopathies. Corticosteroids have been the main treatment for decades and are effective in 70% of minimal-change disease patients and ~30% of focal segmental glomerulosclerosis patients. Multidrug-resistant (steroids, calcineurin-inhibitors, cyclophosphamide, mycophenolate-mofetil, rituximab) idiopathic nephrotic syndrome is a major therapeutic challenge in nephrology. Apheresis (double-filtration plasmapheresis or semi specific immunoadsorption) could act by eliminating the circulating factor (apolipoproteinA1b, solubleCD40L, suPAR) increasing glomerular permeability seen in INS. The aim of the study was to report the outcome of three patients with multidrug-resistant INS treated successfully with apheresis.

Publication types

Case Reports