Beneficial effects of ACTH on the serum lipoprotein profile and glomerular function in patients with membranous nephropathy
(1999) In Kidney International 56(4). p.1534-1543- Abstract
- BACKGROUND: 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... (More)
- BACKGROUND: 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. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1115790
- author
- Berg, Anna-Lena LU ; Nilsson-Ehle, Peter LU and Arnadottir, M
- organization
- publishing date
- 1999
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- adrenocorticotrophic hormone, glomerular filtration rate, lipoprotein(a), nephrotic syndrome, hyperlipoproteinemia
- in
- Kidney International
- volume
- 56
- issue
- 4
- pages
- 1534 - 1543
- publisher
- Nature Publishing Group
- external identifiers
-
- pmid:10504505
- scopus:0032843525
- ISSN
- 1523-1755
- DOI
- 10.1046/j.1523-1755.1999.00675.x
- language
- English
- LU publication?
- yes
- id
- 4aacf45a-5f6f-4c38-ada5-ffe43ac8da4b (old id 1115790)
- date added to LUP
- 2016-04-01 15:46:10
- date last changed
- 2022-01-28 06:55:01
@article{4aacf45a-5f6f-4c38-ada5-ffe43ac8da4b,
abstract = {{BACKGROUND: 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.}},
author = {{Berg, Anna-Lena and Nilsson-Ehle, Peter and Arnadottir, M}},
issn = {{1523-1755}},
keywords = {{adrenocorticotrophic hormone; glomerular filtration rate; lipoprotein(a); nephrotic syndrome; hyperlipoproteinemia}},
language = {{eng}},
number = {{4}},
pages = {{1534--1543}},
publisher = {{Nature Publishing Group}},
series = {{Kidney International}},
title = {{Beneficial effects of ACTH on the serum lipoprotein profile and glomerular function in patients with membranous nephropathy}},
url = {{http://dx.doi.org/10.1046/j.1523-1755.1999.00675.x}},
doi = {{10.1046/j.1523-1755.1999.00675.x}},
volume = {{56}},
year = {{1999}},
}