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dc.contributor.authorBerg, A L
dc.contributor.authorNilsson-Ehle, P
dc.contributor.authorArnadottir, M
dc.date.accessioned2010-07-30T11:29:16Z
dc.date.available2010-07-30T11:29:16Z
dc.date.issued1999-10-01
dc.date.submitted2010-07-30
dc.identifier.citationKidney Int. 1999, 56(4):1534-43en
dc.identifier.issn0085-2538
dc.identifier.pmid10504505
dc.identifier.doi10.1046/j.1523-1755.1999.00675.x
dc.identifier.urihttp://hdl.handle.net/2336/108715
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractBACKGROUND: Previous studies have shown that short-term treatment with adrenocorticotrophic hormone (ACTH) has a strong and rapid lipid-lowering effect. In this long-term study of nephrotic patients with idiopathic membranous nephropathy, the influence of ACTH on the serum lipoprotein profile and glomerular function as well as the dose-effect relationship was investigated. METHODS: Fourteen patients received ACTH intramuscularly at increasing doses during 56 days. Serum concentrations of lipids, lipoproteins, and apolipoproteins as well as variables of glomerular function were analyzed, and the side-effects were recorded. ACTH treatment, in the estimated optimal dosage, was then continued in five patients with severe steroid-resistant nephrotic syndrome. In these five patients, the total treatment period was 12 months, and the follow-up time after discontinuing treatment was 18 months. RESULTS: Taking both the statistically significant therapeutic effects and the modest side-effects into consideration, the optimal dosage of ACTH was estimated to be 1 mg twice per week. At that dose, reductions by 30 to 60% in the serum concentrations of cholesterol, triglycerides, apolipoprotein B, and lipoprotein(a) were observed, whereas the serum concentrations of high-density lipoprotein cholesterol and apolipoprotein AI rose by 30 to 40%. In addition, the urinary albumin excretion decreased by 90%, and the glomerular filtration rate increased by 25%. Deterioration was observed in all cases when ACTH was discontinued after a treatment duration of 56 days. However, the five patients in whom ACTH therapy was resumed were still in remission 18 months after discontinuance of treatment. CONCLUSIONS: In nephrotic patients with idiopathic membranous nephropathy, treatment with ACTH 1 mg twice per week was associated with significant long-term improvements in serum lipoprotein pattern and glomerular function.
dc.language.isoenen
dc.publisherNature Publishing Groupen
dc.relation.urlhttp://dx.doi.org/10.1046/j.1523-1755.1999.00675.xen
dc.subject.meshAdrenocorticotropic Hormoneen
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshAlbuminuriaen
dc.subject.meshApolipoproteins Aen
dc.subject.meshApolipoproteins Ben
dc.subject.meshCholesterol, HDLen
dc.subject.meshCholesterol, LDLen
dc.subject.meshFemaleen
dc.subject.meshFollow-Up Studiesen
dc.subject.meshGlomerular Filtration Rateen
dc.subject.meshGlomerulonephritis, Membranousen
dc.subject.meshHumansen
dc.subject.meshHydrocortisoneen
dc.subject.meshHyperlipoproteinemiasen
dc.subject.meshKidney Glomerulusen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshNephrotic Syndromeen
dc.subject.meshSerum Albuminen
dc.titleBeneficial effects of ACTH on the serum lipoprotein profile and glomerular function in patients with membranous nephropathyen
dc.typeArticleen
dc.contributor.departmentDepartment of Nephrology and Institute of Laboratory Medicine, Lund University, Sweden.en
dc.identifier.journalKidney internationalen
html.description.abstractBACKGROUND: Previous studies have shown that short-term treatment with adrenocorticotrophic hormone (ACTH) has a strong and rapid lipid-lowering effect. In this long-term study of nephrotic patients with idiopathic membranous nephropathy, the influence of ACTH on the serum lipoprotein profile and glomerular function as well as the dose-effect relationship was investigated. METHODS: Fourteen patients received ACTH intramuscularly at increasing doses during 56 days. Serum concentrations of lipids, lipoproteins, and apolipoproteins as well as variables of glomerular function were analyzed, and the side-effects were recorded. ACTH treatment, in the estimated optimal dosage, was then continued in five patients with severe steroid-resistant nephrotic syndrome. In these five patients, the total treatment period was 12 months, and the follow-up time after discontinuing treatment was 18 months. RESULTS: Taking both the statistically significant therapeutic effects and the modest side-effects into consideration, the optimal dosage of ACTH was estimated to be 1 mg twice per week. At that dose, reductions by 30 to 60% in the serum concentrations of cholesterol, triglycerides, apolipoprotein B, and lipoprotein(a) were observed, whereas the serum concentrations of high-density lipoprotein cholesterol and apolipoprotein AI rose by 30 to 40%. In addition, the urinary albumin excretion decreased by 90%, and the glomerular filtration rate increased by 25%. Deterioration was observed in all cases when ACTH was discontinued after a treatment duration of 56 days. However, the five patients in whom ACTH therapy was resumed were still in remission 18 months after discontinuance of treatment. CONCLUSIONS: In nephrotic patients with idiopathic membranous nephropathy, treatment with ACTH 1 mg twice per week was associated with significant long-term improvements in serum lipoprotein pattern and glomerular function.


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