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低密度脂蛋白单采术有助于重度糖尿病肾病患者延长生存期及维持肾功能:一项回顾性分析

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

作者信息

Sato Eiichi, Amaha Mayuko, Nomura Mayumi, Matsumura Daisuke, Ueda Yoshihiko, Nakamura Tsukasa

机构信息

Shin-Matsudo Central General Hospital, Japan; Department of Pathology, Dokkyo Medical University, Koshigaya Hospital, Japan.

Shin-Matsudo Central General Hospital, Japan.

出版信息

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.

摘要

目的

低密度脂蛋白(LDL)单采去除包括LDL/氧化型LDL和炎性细胞因子在内的多种分子,并使临床实验室指标恢复正常。LDL单采的这些优势是否能改善伴有肾病综合征的糖尿病肾病患者的预后尚不清楚。

方法

在本研究中,对单中心的三组患者进行回顾性调查,并随访约3年:LDL单采队列(LDL-a;N = 20);符合严重蛋白尿≥3g/24h选择标准的对照队列(对照-全部;N = 55);以及蛋白尿更严重(≥5g/24h)的对照-全部亚组(对照-mSP;N = 10),并将生存、肾功能不全和无死亡/肾功能不全率作为评估结果。

结果

LDL-a组的无死亡/肾功能不全率显著高于对照-全部组(χ(2)=4.50;P = 0.03)和对照-mSP组(χ(2)=27.68;P < 0.001)。

结论

这些结果提示LDL单采可能有助于延长重度糖尿病肾病患者的生存期并维持其肾功能。

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