Abstract
Results of recent animal studies have lent support to the hypothesis that hyperlipidaemia may contribute to renal injury. This report documents the case of a 15-year-old boy with drug-resistant nephrotic syndrome due to focal segmental glomerulosclerosis (FGS) who showed an improvement in renal function and proteinuria as a result of treatment with low-density lipoprotein aphaeresis (LDL-A) combined with pravastatin. Although further work is required to determine the efficacy of lipidlowering therapy in progressive glomerular disease in humans, the combination of LDL-A and pravastatin is likely be included in the choice of treatment modalities available for patients with drug-resistant nephrotic syndrome due to FGS.
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References
Moorhead JF (1991) Lipids and progressive kidney disease. Kidney Int 39 [Suppl 31]: S35-S40
Keane WF, Mulcahy WS, Kasiske BL, Kim Y, O'Donnell MP (1991) Hyperlipidemia and progressive renal disease. Kidney Int 39 [Suppl 31]: S41-S48
Tojo K, Sakai S, Miyahara T (1988) Possible therapeutic application of low density lipoprotein apheresis (LDL-A) in conjunction with double filtration plasmapheresis (DFPP) in drug-resistant nephrotic syndrome due to focal glomerular sclerosis (FGS). Jpn J Nephrol 30: 1153–1160
Yokoyama S, Hayashi R, Kikkawa T, Tani N, Takada S, Hatanaka K, Yamamoto A (1984) Specific sorbent of apolipoprotein B-containing lipoproteins for plasmapheresis: characterization and experimental use in hypercholesterolemic rabbits. Arteriosclerosis 4: 276–282
Mabuchi H, Michishita I, Takeda M, Fujita H, Koizumi J, Takeda R, Takada S, Oonishi M (1987) A new low density lipoprotein apheresis system using two dextran sulfate cellulose columns in an automated column regenerating unit (LDL continuous apheresis). Atherosclerosis 68: 19–25
Diamond JR, Karnovsky MJ (1987) Exacerbation of chronic aminonucleoside nephrosis by dietary cholesterol supplementation. Kidney Int 32: 671–677
Harris KPG, Purkerson ML, Yates J, Klahr S (1990) Lovastatin ameliorates the development of glomerulosclerosis and uremia in experimental nephrotic syndrome. Am J Kidney Dis 15: 16–23
Rabelink AJ, Hene RJ, Erkelens DW, Joles JA, Koomans HA (1990) Partial remission of nephrotic syndrome in patient on long-term simvastatin. Lancet 335: 1045–1046
Strauss J, Zilleruelo G, Freundlich M, Abitol C (1987) Less commonly recognized features of childhood nephrotic syndrome. Pediatr Clin North Am 34: 591–590
Block LH, Pletscher A (1988) Low-density lipoprotein: an old substance with a new function? TIPS 9: 214–216
Kaplan R, Aynedjian HS, Bank N, Schlorndorff DO (1990) Cholesterol feeding causes renal vasoconstriction via oxidized lipoprotein activation of thromboxane. Kidney Int 37: 371A
Remuzzi G, Imberti L, Rossini M (1985) Increased glomerular thromboxane synthesis as a possible cause of proteinuria in experimental nephrosis. J Clin Invest 75: 94–101
Benigni A, Rizzoni G, Antolini A, Piccinelli A, Remuzzi G (1990) Preliminary report: renal thromboxane A2 synthesis in children with frequent relapsing nephrotic syndrome. Lancet 336: 533–534
Patrono C, Ciabattoni G, Patrignani P, Filabozzi P, Pinca E, Satta MA, Van Dorne D, Cinotti GA, Pugliese F, Pierucci A, Simonetti BM (1983) Evidence for a renal origin of urinary thromboxane B2 in health and disease. Adv Prostaglandin Thromboxane Leukotriene Res 11: 493–498
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Hattori, M., Ito, K., Kawaguchi, H. et al. Treatment with a combination of low-density lipoprotein aphaeresis and pravastatin of a patient with drug-resistant nephrotic syndrome due to focal segmental glomerulosclerosis. Pediatr Nephrol 7, 196–198 (1993). https://doi.org/10.1007/BF00864397
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DOI: https://doi.org/10.1007/BF00864397