Amelioration of steroids and cyclosporine-resistant nephrotic syndrome by pravastatin

An update on LDL apheresis for nephrotic syndrome

Low-density lipoprotein (LDL) apheresis has been used increasingly in clinical practice for the treatment of renal diseases with nephrotic syndrome (NS), specifically focal segmental glomerulosclerosis (FSGS). Persistent hyperlipidemia for prolonged periods is nephrotoxic and leads to chronic progressive glomerular and tubulointerstitial injury. Effective management of hyperlipidemia with HMG-CoA reductase inhibitors or LDL apheresis in drug-resistant NS patients may prevent the progression of renal disease and, in some patients, resolution of NS symptoms. Available literature reveals beneficial effects of LDL apheresis for NS refractory to drug therapy. Here we update on the current understanding of lipid nephrotoxicity and application of LDL apheresis to prevent progression of renal diseases.

Nanoarchitectures in dye-sensitized solar cells: metal oxides, oxide perovskites and carbon-based materials

Dye-sensitized solar cells (DSSCs) have aroused great interest and been regarded as a potential renewable energy resource among the third-generation solar cell technologies to fulfill the 21^st century global energy demand. DSSCs have notable advantages such as low cost, easy fabrication process and being eco-friendly in nature. The progress of DSSCs over the last 20 years has been nearly constant due to some limitations, like poor long-term stability, narrow absorption spectrum, charge carrier transportation and collection losses and poor charge transfer mechanism for regeneration of dye molecules. The main challenge for the scientific community is to improve the performance of DSSCs by using different approaches, like finding new electrode materials with suitable nanoarchitectures, dyes in composition with promising semiconductors and metal quantum dot fluorescent dyes, and cost-effective hole transporting materials (HTMs). This review focuses on DSSC photo-physics, which includes charge separation, effective transportation, collection and recombination processes. Different nanostructured materials, including metal oxides, oxide perovskites and carbon-based composites, have been studied for photoanodes, and counter electrodes, which are crucial to achieve DSSC devices with higher efficiency and better stability.

Immediate therapeutic efficacy of low-density lipoprotein apheresis for drug-resistant nephrotic syndrome: evidence from the short-term results from the POLARIS Study

BACKGROUND

Hyperlipidemia is not merely a complication but a major exacerbating factor in longstanding nephrotic syndrome (NS). Low-density lipoprotein apheresis (LDL-A) has been reported to ameliorate dyslipidemia and induce rapid remission of NS. Several clinical studies have suggested the therapeutic efficacy of LDL-A, but the level of clinical evidence is insufficient. Therefore, a multicenter prospective study, POLARIS (Prospective Observational Survey on the Long-Term Effects of LDL Apheresis on Drug-Resistant Nephrotic Syndrome), was initiated in Japan.

METHOD

Patients with drug-resistant NS were prospectively recruited into the study and treated with LDL-A in facilities that were registered in advance. In the POLARIS study design, the clinical data are to be followed up for 2 years. In the current study, we aimed at evaluating the short-term efficacy based on the treatment outcome of LDL-A immediately after completion of treatment.

RESULTS

Along with rapid improvement of hyperlipidemia, LDL-A significantly improved proteinuria and hypoproteinemia after treatment. More than half of the patients showed remission of NS based on the urinary protein level at the completion of LDL-A. The duration of NS before the start of treatment was significantly shorter in patients who responded to LDL-A.

CONCLUSIONS

An analysis of patients registered in the POLARIS study indicated that LDL-A has short-term efficacy for drug-resistant NS. Rapid relief of dyslipidemia by LDL-A may provide early remission in about half of the NS patients who are resistant to conventional medication. Completion of the POLARIS study may reveal additional long-term effects of LDL-A in these patients.