Premium
Therapeutic Potential of Low‐Density Lipoprotein Apheresis in the Management of Peripheral Artery Disease in Patients With Chronic Kidney Disease
Author(s) -
Tamura Kouichi,
TsurumiIkeya Yuko,
Wakui Hiromichi,
Maeda Akinobu,
Ohsawa Masato,
Azushima Kengo,
Kanaoka Tomohiko,
Uneda Kazushi,
Haku Sona,
Azuma Koichi,
Mitsuhashi Hiroshi,
Tamura Nobuko,
Toya Yoshiyuki,
Tokita Yasuo,
Kokuho Toshiharu,
Umemura Satoshi
Publication year - 2013
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/j.1744-9987.2012.01149.x
Subject(s) - medicine , dyslipidemia , kidney disease , diabetes mellitus , disease , dialysis , coronary artery disease , apheresis , cardiology , vascular disease , risk factor , population , hemodialysis , endocrinology , platelet , environmental health
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.