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Efficacy of Low-Density Lipoprotein Apheresis in Patients with Peripheral Arterial Occlusive Disease Undergoing Hemodialysis Treatment
- Source :
- American Journal of Nephrology. 27:643-648
- Publication Year :
- 2007
- Publisher :
- S. Karger AG, 2007.
-
Abstract
- 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.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Pain
Flow mediated dilation
Arterial Occlusive Diseases
Renal Dialysis
Peripheral arterial occlusive disease
Internal medicine
medicine
Humans
In patient
Endothelial dysfunction
Low density lipoprotein apheresis
Triglycerides
Aged
Aged, 80 and over
Vascular Endothelial Growth Factors
business.industry
Endothelial Cells
Cholesterol, LDL
Middle Aged
medicine.disease
Lipoproteins, LDL
Vasodilation
Cholesterol
Treatment Outcome
Apheresis
Nephrology
Blood Component Removal
Cardiology
Kidney Failure, Chronic
Female
lipids (amino acids, peptides, and proteins)
Hemodialysis
business
Lipoprotein
Subjects
Details
- ISSN :
- 14219670 and 02508095
- Volume :
- 27
- Database :
- OpenAIRE
- Journal :
- American Journal of Nephrology
- Accession number :
- edsair.doi.dedup.....5f9dc23263cbf9281bb12ee0344b4741