Chinese Journal of Nephrology, Dialysis & Transplantation
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Abstract: Objective:To retrospectively observe the clinical efficacy of double fltration plasmapheresis(DFPP) in patients with lipoprotein glomerulopathy(LPG). Methodology:17 Patients with biopsyproven LPG who received DFPP treatment in our center from 2010 to 2016 were involved,clinical parameters before and after DFPP treatment were recorded and analyzed. Results:Fifteen of the patients underwent 310 courses of DFPP,and 2 patients were unable to tolerate DFPP due to allergic reactions.All patients received fenofibrate or statins and other relevant symptomatic treatments.After shortterm DFPP treatments,serum creatinine(SCr 15558±7691 μmol/L vs 13702±7337 μmol/L,P<001),plasma apolipoprotein E(794±187 mg/dl vs 358±132 mg/dl,P<001)and proteinuria (468±250 g/24h vs 270±220 g/24h,P<001),were relieved significantly.1 patient (67%) achieved complete remission of proteinuria,and 5 patients (333%) achieved partial remission of proteinuria.Four patients underwent repeated renal biopsy after DFPP treatment,and 2 of them who received 10 courses of DFPP were observed disappearment of intraglomerular lipoprotein thrombi,and negative ApoE staining.While 2 patients who underwent only 3 and 4 courses of DFPP respectively showed no significant pathological improvement.After a median followup of 7 month(IQR 1~32),all patients had elevated ApoE level,4 patients showed an elevation trend of SCr.Three of the four patients who had got partially or completely remission of proteinuria after DFPP tend to be stable after 12 months followup. Conclusion:Shortterm efficacy of DFPP in patients with LPG was definite.However,Scr and ApoE levels rebounded in some patients during longterm followup.
FAN Wenjing,YANG Fan*,CHENG Zhen, et al. Efficacy of double filtration plasmapheresis therapy on patients with lipoprotein glomerulopathy[J]. Chinese Journal of Nephrology, Dialysis & Transplantation, DOI: 10.3969/j.issn.1006-298X.2020.02.002.
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URL: http://www.njcndt.com/EN/10.3969/j.issn.1006-298X.2020.02.002
http://www.njcndt.com/EN/Y2020/V29/I2/108