維持血液透析患者におけるASOに対するLDLアフェレシス(<特集>心疾患とアフェレシス)

概要

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Cardiovascular disease (CVD) is the primary cause of death in patients with end-stage renal disease (ESRD). Patients on dialysis are reported to have a 10- to 20-fold 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. The patients undergoing dialysis have many risk factors for atherosclerosis, such as hypertension, dyslipidemia, and disturbed calcium-phosphate metabolism, and suffer from severe atherosclerosis, including peripheral arterial diseases (PAD). Chronic kidney disease itself is also an independent risk factor for the development of atherosclerosis. Low-density lipoprotein (LDL) apheresis is a possible treatment applied to conventional therapy-resistant hypercholesterolemic patients with coronary artery disease and PAD. Although previous and recent studies suggest that LDL apheresis exerts beneficial effects on the peripheral circulation in ESRD patients suffering from PAD through a reduction of not only serum lipids but also inflammatory or coagulatory activity and oxidative stress, the precise molecular mechanism of the long-term effects of LDL apheresis on the improvement of the peripheral circulation remains unclear and warrants further investigation.
2010-05-31