WCN26-4982 RAB11A AND RAB11B FUNCTION REDUNDANTLY TO MAINTAIN PODOCYTE FOOT PROCESS ARCHITECTURE AND GLOMERULAR FILTRATION BARRIER INTEGRITY

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incomplete remission (type II IR; UP<3.5 g/day but ALB < 3.0 g/dl), and no improvement in NS (NS; UP> 3.5 g / day and ALB < 3.0 g/dl).LDL-A was performed using polysulphone hollow fibers (Sulflux; Kaneka Corp., Japan) for plasma separation and a dextran sulfate cellulose column (Liposorber LA-15; Kaneka Corp., Japan) as the LDL adsorber.Results: Patient profile and LDLA session: Age of patients ranged from 14 to 68 years, and two patients were younger than 16 years of age.The average duration of drug treatment without response before LDL-A after the last onset of NS in 25 patients was 2.7 months..A total of two to thirteen (7.6 ± 3.5) sessions of LDL-A were combined with steroid (n=26) and/or CsA (n=11), other immunosuppressive drugs (n=4), or statins (n=10) as lipid-lowering agents.Outcome:Mean levels of TC, UP, TP, and ALB were significantly improved at 0-1 and 1-3 months.TC and UP decreased to 219 mg/dL and 0.86 g/day at 1-3 months, respectively.In 16 patients (76%), UP was less than 1.0 g/day at 1-3 months.TP and ALB increased to 5.52 g/dL and 3.55 g/dL at 1-3 months, respectively.In 21 patients (88%), ALB was above 3.0 g/dL at 1-3 months.Cr and Ccr exhibited tendencies toward improvement at 0-1 and 1-3 months, though significant improvement was observed only in Cr at 0-1 months.At the 2nd year, 16 patients (84%), 2 patients (11%), 1 patient (5%) , and no patients were classified as in CR, Type I IR, Type II IR, and NS, respectively.At the 5th year, 8 patients (80%), 2 patients (20%), and no patients were classified as in CR, Type II IR, and NS, respectively.There was no patient diagnosed as chronic renal failure (CRF).The decrease in TC at 0-1 months was significantly correlated with the decrease in UP at 0-1 months (r=0.451,p=0.018) and the increase in ALB at 0-1 months (r=0.630,p<0.001) Conclusion: LDL apheresis treatment in combination with drug treatment is effective in achieving rapid remission and good long-term outcome in patients with refractory MCNS.Approval of this therapy for MCNS is highly expected to reduce the long term and high dose use of steroid in drug resistant cases.I have potential conflict of interest to disclose.

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