MORIMOTO Satoshi
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Associate Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Efficacy of low-density lipoprotein apheresis in patients with peripheral arterial occlusive disease undergoing hemodialysis treatment.
Journal Formal name:American journal of nephrology
Abbreviation:Am J Nephrol
ISSN code:14219670/02508095
Domestic / ForeginForegin
Volume, Issue, Page 27(6),pp.643-8
Author and coauthor Morimoto Satoshi†*, Yano Yutaka, Maki Kei, Sawada Katsunori, Iwasaka Toshiji
Authorship Lead author,Corresponding author
Publication date 2007
Summary BACKGROUND:Low-density lipoprotein (LDL) apheresis is effective in the treatment of peripheral arterial occlusive disease (PAOD). In the present study, we attempted to determine whether LDL apheresis is effective even for PAOD patients undergoing hemodialysis, who tend to be refractory to any treatment, and if so, to determine the mechanism of its efficacy.METHODS:Serum levels of lipids and vascular growth factors, leg symptom, and endothelium-dependent vasodilation were investigated before and after 10 sessions of LDL apheresis in 11 PAOD patients undergoing hemodialysis.RESULTS:Serum levels of total cholesterol, LDL cholesterol, and triglyceride exhibited drastic reduction, which completely disappeared 4 weeks after the final apheresis. Resting leg pain was improved in 6 cases even 4 weeks after final apheresis. Endothelium-dependent vasodilation was significantly increased 4 weeks after final apheresis (1.6 +/- 0.6 to 4.7 +/- 1.0%, p < 0.05). Levels of vascular growth factors, hepatocyte growth factor and vascular endothelial growth factor were not changed during treatment.CONCLUSIONS:These findings suggested that LDL apheresis is effective even in PAOD patients undergoing hemodialysis. Our findings suggest that its mechanisms of efficacy include improvement of vascular endothelial dysfunction, in addition to drastic but acute reduction of lipid levels. Since PAOD patients undergoing hemodialysis tend to be resistant to any treatment and are at high risk for lower-extremity amputation, LDL apheresis could be a useful strategy for treatment of them.
DOI 10.1159/000108634
PMID 17878713