Short-term Effect of LDL-Apheresis on Lipid Profile of Patients with Nephrotic and Non-Nephrotic Hyperlipidemia: A Comparative Study
Abduzhappar Gaipov 1 * , Assem Nogaibayeva 2, Zaiyrkhan Turebekov 2 , Lyazzat Zharmukhanbet 2 , Gani Orazbayev 3 , Dmitriy Malykh 4 , Natalya Kim 5 , Anara Abbay 1 , Saltanat Tuganbekova 6, Mohamad Aljofan 7 , Bolat Bekishev 8
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1 Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, KAZAKHSTAN2 Department of Extracorporeal Hemocorrection, National Scientific Medical Center, Nur-Sultan, KAZAKHSTAN3 Department of Extracorporeal Hemocorrection, The Medical Centre Hospital of the President’s Affairs Administration of the Republic of Kazakhstan, Nur-Sultan, KAZAKHSTAN4 Department of Internal Medicine, Marienhospital, Mülheim an der Ruhr, GERMANY5 Department of Clinical and Diagnostic Laboratory, National Scientific Medical Center, Nur-Sultan, KAZAKHSTAN6 Department of Internal Medicine, National Scientific Medical Center, Nur-Sultan, KAZAKHSTAN7 Department of Biomedical Sciences, Nazarbayev University School of Medicine, Nur-Sultan, KAZAKHSTAN8 Department of Extracorporeal Hemocorrection, National Research Cardiac Surgery Center, Nur-Sultan, KAZAKHSTAN* Corresponding Author

Abstract

Background: Persistent hyperlipidemia is a major cause of cardiovascular morbidity in patients with nephrotic and non-nephrotic patients. Low-density lipoprotein-apheresis (LDL-apheresis) was shown to rapidly remove lipid structures. The current study aimed to compare the initial lipid profiles in patients with nephrotic syndrome and non-nephrotic hyperlipidemia as well as to evaluate the lipid profile of each group following a single treatment with LDL-apheresis.
Methods: This is an open-label observational cross-sectional study of patients treated with LDL-apheresis including ten patients with nephrotic syndrome and thirteen patients with non-nephrotic hyperlipidemia who were either resistant and/or intolerant of lipid lowering therapy, with normal kidney function. Routine blood tests with full traditional lipid profile (Total cholesterol-(TC), Low-density lipoprotein (LDL), High-density lipoprotein (HDL), Triglycerides-(TG)) were determined before and after 12-hours following a single LDL-apheresis procedure.
Results: Both groups were comparable by sex and age with more males than female in both groups. Baseline lipid profile was different between the two groups with nephrotic syndrome patients having significantly higher TC (p=0.05), LDL (p<0.001) and HDL (p<0.02) than those with non-nephrotic hyperlipidemia. A single treatment with LDL-apheresis resulted in significant improvements in the lipid profile of both groups including TC, HDL, LDL and TG, however HDL not significantly reduced in patients with nephrotic syndrome.
Conclusion: Resistant nephrotic syndrome patients have a more severe and persistent hyperlipidemia than patients with non-nephrotic hyperlipidemia. The current study shows that LDL-apheresis is a safe and effective alternative to those who cannot tolerate or resistant to conventional treatments.

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Original Article

ELECTRON J GEN MED, Volume 18, Issue 3, June 2021, Article No: em295

https://doi.org/10.29333/ejgm/10861

Publication date: 27 Apr 2021

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