Esnault VLM, Baranger TAR, Besnier D, Testa A, Lucas P,
Coville L et al
Protein a immunoadsorbtion (IA) reduces proteinuria in
nephrotic syndrome (NS) of various aetiologies despite albumin
loss correction
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1332 1996
Protein A immunoadsorption (IA) has been reported to reduce proteinuria in
recurrent focal glomerulosclerosis after transplantation. In this study,
the authors also tested the effects of PA immunoadsorption on the degree of
proteinuria in various causes of nephrotic syndrome (diabetes, IgA,
amyloidosis). 9 patients underwent IA. A rapid fall of proteinuria was
observed after 3 to 5 IA, from 12.6 to 3.3 g/d. However, a concomitant
decrease in serum albumin occurred from 25.4 to 18.7 g/l. To test the
responsibility of serum albumin decrease in the reduction in daily
proteinuria, the authors infused albumin intravenously in 2 patients after
each IA. These patients expressed a comparable decrease in
proteinuria, from 13.4 to 5.0 and 8.0 to 0.6 g/d, suggesting that IA was
able to remove a nonspecific circulating factor responsible for nephrotic
range proteinuria in these patients.
(Denis Fouque, M.D., University of Lyons, France)
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Am Soc Nephrol
Nephrotic Syndrome :
Treatment (CEI, indomethacin, lipid drugs)