Low-density Lipoprotein Receptor Activities, Lipids, Apolipoprotein, and Clinical Course of Patients with Steroid-resistant Nephrotic Syndrome Treated with Low-density Lipoprotein Apheresis: A Case Series

We herein report three cases of steroid-resistant nephrotic syndrome successfully treated with low-density lipoprotein apheresis (LDL-A). All patients were treated with a combination of steroids, cyclosporine, and LDL-A. In all cases, the serum concentrations of LDL, total and high-density lipoprote...

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Bibliographic Details
Published in:Internal Medicine 2024/02/01, Vol.63(3), pp.433-438
Main Authors: Shima, Hisato, Higashiguchi, Yusuke, Doi, Toshio, Harada, Megumi, Okamoto, Takuya, Inoue, Tomoko, Tashiro, Manabu, Okada, Kazuyoshi, Minakuchi, Jun
Format: Article
Language:English
Subjects:
Apheresis
Apolipoproteins
Apolipoproteins - therapeutic use
Blood Component Removal
Case Report
Cholesterol
Cyclosporine - therapeutic use
Cyclosporins
Disease Progression
focal segmental glomerulosclerosis
Glomerulosclerosis, Focal Segmental
High density lipoprotein
Humans
hyperlipidemia
LDL receptor activity
Lipids
Lipoproteins, LDL - therapeutic use
Low density lipoprotein
Low density lipoprotein receptors
low-density lipoprotein apheresis
Nephrotic syndrome
Nephrotic Syndrome - drug therapy
Receptor density
Receptors, LDL
Steroid hormones
Triglycerides
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Summary:We herein report three cases of steroid-resistant nephrotic syndrome successfully treated with low-density lipoprotein apheresis (LDL-A). All patients were treated with a combination of steroids, cyclosporine, and LDL-A. In all cases, the serum concentrations of LDL, total and high-density lipoprotein cholesterol, and triglycerides were significantly lowered following LDL-A administration. Furthermore, the estimated LDL receptor activity increased, while both serum LDL and total cholesterol levels decreased, suggesting that LDL-A increases LDL receptor activity by driving changes in serum cholesterol concentration. This case series suggests that LDL-A increases LDL receptor activity, which may improve the intracellular uptake of cyclosporine.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.1922-23