Therapeutic potential of low-density lipoprotein apheresis in the management of peripheral artery disease in patients with chronic kidney disease.

Abstract

Cardiovascular disease (CVD) is a major cause of death in patients with chronic kidney disease (CKD). Patients with CKD are reported to have a significant greater risk of CVD-associated mortality than that of the general population after stratification for age, gender, race, and the presence or absence of diabetes. CKD itself is also an independent risk factor for the development of atherosclerosis, and in particular, patients undergoing dialysis typically bear many of the risk factors for atherosclerosis, such as hypertension, dyslipidemia and disturbed calcium-phosphate metabolism, and commonly suffer from severe atherosclerosis, including peripheral arterial disease (PAD). Low-density lipoprotein (LDL) apheresis is a potentially valuable treatment applied to conventional therapy-resistant hypercholesterolemic patients with coronary artery disease and PAD. Although previous and recent studies have suggested that LDL apheresis exerts beneficial effects on the peripheral circulation in dialysis patients suffering from PAD, probably through a reduction of not only serum lipids but also of inflammatory or coagulatory factors and oxidative stress, the precise molecular mechanisms underlying the long-term effects of LDL apheresis on the improvement of the peripheral circulation remains unclear and warrants further investigation.

• Authors: Kouichi Tamura, Yuko Tsurumi-Ikeya, Hiromichi Wakui, Akinobu Maeda, Masato Ohsawa, Kengo Azushima, Tomohiko Kanaoka, Kazushi Uneda, Sona Haku, Koichi Azuma, Hiroshi Mitsuhashi, Nobuko Tamura, Yoshiyuki Toya, Yasuo Tokita, Toshiharu Kokuho, Satoshi Umemura
• Journal: Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy (Ther Apher Dial) Vol. 17 Issue 2 Pg. 185-92 (Apr 2013) ISSN: 1744-9987 [Electronic] Australia
• PMID: 23551675 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
• Copyright: © 2012 The Authors. Therapeutic Apheresis and Dialysis © 2012 International Society for Apheresis.

Chemical References

• Cholesterol, LDL

Topics

• Blood Component Removal (methods)
• Cardiovascular Diseases (physiopathology, therapy)
• Cholesterol, LDL (blood)
• Humans
• Hypercholesterolemia (therapy)
• Oxidative Stress
• Peripheral Arterial Disease (physiopathology, therapy)
• Renal Insufficiency, Chronic (physiopathology, therapy)
• Risk Factors