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Abstract: PO1164

Efficacy of Double Filtration Plasmapheresis Therapy on Patients with Lipoprotein Glomerulopathy

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Fan, Wenjing, Nanjing General Hospital of Nanjing Military Command Research Institute of Nephrology, Nanjing, Jiangsu, China
  • Ge, Yongchun, Nanjing General Hospital of Nanjing Military Command Research Institute of Nephrology, Nanjing, Jiangsu, China
  • Dong, Jianhua, Nanjing General Hospital of Nanjing Military Command Research Institute of Nephrology, Nanjing, Jiangsu, China
Background

To Retrospectively observe the clinical efficacy of double fltration plasmapheresis(DFPP) in patients with lipoprotein glomerulopathy(LPG).

Methods

17 Patients with biopsy-proven LPG in our center who received DFPP treatment from 2010 to 2016 were involved, clinical parameters before and after DFPP treatment were recorded and analyzed.

Results

15 of the patients underwent 3-10 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 short-term DFPP treatments, serum creatinine(Scr, 1.76±0.87mg/dl vs 1.55±0.83mg/dl,P<0.01), plasma apolipoprotein E(7.94±1.87mg/dl vs 3.58±1.32mg/dl,P<0.01)and proteinuria (4.68±2.50g/24h vs 2.70±2.20g/24h,P<0.01),were relieved significantly . 1 patient (6.7%) achieved complete remission of proteinuria, and 5 patients (33.3%) 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 follow-up of 7 month(IQR 31.5-1), all patients had elevated ApoE level, 4 patients showed an elevation trend of Scr. 3 of the 4 patients who had got partially or completely remission of proteinuria after DFPP tend to be stable after 12 months’ follow-up.

Conclusion

Short-term efficacy of DFPP in patients with LPG was definite. However, Scr and ApoE levels rebounded in some patients during long-term follow-up