LDL-apheresis contributes to survival extension and renal function maintenance of severe diabetic nephropathy patients: a retrospective analysis

Diabetes Res Clin Pract. 2014 Nov;106(2):241-6. doi: 10.1016/j.diabres.2014.08.012. Epub 2014 Sep 3.

Abstract

Aims: Low-density lipoprotein (LDL)-apheresis removes various molecules including LDL/oxidized LDL and inflammatory cytokines and recovers clinical laboratory parameters. It is not yet known whether these advantages of LDL-apheresis improve the prognosis of patients with diabetic nephropathy accompanied by nephrotic syndrome.

Methods: In this study, three groups of patients were retrospectively surveyed in a single center, and followed for approximately 3 years: an LDL-apheresis cohort (LDL-a; N = 20); a control cohort meeting the selection criterion of severe proteinuria ≥ 3g/24h (control-All; N = 55); and a subgroup of control-All with more severe proteinuria ≥ 5 g/24h (control-mSP; N = 10), and evaluated the outcomes as survival and renal dysfunction and death/renal dysfunction free rate.

Results: Death/renal dysfunction free rate was significantly higher in LDL-a than control-All (χ(2) = 4.50; P = 0.03) and control-mSP (χ(2) = 27.68; P < 0.001).

Conclusion: These results suggest the possibilities which LDL-apheresis is considered to contribute to survival extension and renal function maintenance of severe diabetic nephropathy patients.

Keywords: Diabetic nephropathy; LDL-apheresis; Nephrotic syndrome; Retrospective study.

MeSH terms

  • Aged
  • Blood Component Removal / methods*
  • Diabetic Nephropathies / blood
  • Diabetic Nephropathies / mortality
  • Diabetic Nephropathies / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Japan / epidemiology
  • Lipoproteins, LDL / blood*
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Severity of Illness Index
  • Survival Rate / trends

Substances

  • Lipoproteins, LDL