The Effect of Antiproteinuric Treatment on Lipid Levels in Patients with Focal Segmental Glomerulosclerosis and Membranous Glomerulopathy

OBJECTIVE: The primary objective of our study was to investigate effects of antiproteinuric treatment on lipid levels of patients with idiopathic focal segmental glomerulosclerosis (FSGS) or membranous glomerulonephritis (MGN).

MATERIAL and METHODS: The clinical and laboratory data of the patients were recorded at three-month intervals during 18 months of follow-up. Patients with non-nephrotic proteinuria without hypoalbuminemia received conservative treatment while those with more severe disease received steroid therapy as well. Lipid parameters in the two groups and the factors effective on these parameters were investigated.

RESULTS: Sixty eight patients (36 with FSGS, 32 with MG) were included. The mean age of the patients and the follow-up period were 39.6±16.6 years and 16.4±8.9months, respectively. 36 (53%) patients received steroid therapy. The percentage of patients taking antilipemic treatment was statistically significantly higher in the group taking steroid therapy. LDL cholesterol levels were higher at the beginning in patients taking steroid therapy but the difference disappeared after the ninth month. Total and LDL cholesterol levels showed a negative correlation with albumin levels and a positive correlation with proteinuria level.

CONCLUSION: Treatment of hyperlipidemia in nephrotic syndrome should be directed towards increasing serum albumin levels, and therefore treatment of the glomerular disease. Antilipidemic therapies should be considered in patients who do not respond to other antiproteinuric treatment.