Fenofibrate In The Treatment Of Lipoprotein Glomerulopathy-A Retrospective Study In Chinese Patients

Objective:Lipoprotein glomerulopathy is a rare inherited disease caused by the abnormal metabolism of Apolipoprotein E(ApoE).The objective of this study is to observe the effect of fenofibrate in Chinese patients with lipoprotein glomerulopathy(LPG).Method:From 2003 to 2013,45 patients were diagnosed LPG in our hospital and 30 of them were followed up for more than 2 years.Patients who recieved fenofibrate at a dose of 200-400mg/d for at least 24 months were assigned to Brate group(n=15),and patients who didn't recieve fenofibrate were assigned to control group(n= 15).Results:1.Baseline:The baseline parameters of the 2 groups(serum creatinine,albumin,ApoE levels and urine protein)were not significantly different(P>0.05).2.Clinical effect:After 24 months' treatment,lipid profiles,proteinuria,and serum albumin improved in patients in Brate group.In Brate group,the urinary albumin was lower after 12 to 24months,treatment(3.10±2.87 vs 1.43±1.35 vs 1.03±0.79g/24h),serum creatinine was decreased slightly(92.82±26.52 vs 91.05±5.52 vs 90.17±22.98),and serum albumin was increased(36.86±7.73 vs 43.57±6.28 vs 43.32±5.94g/L).However,the post-treatment parameters in the control group deteriorated.3.Prognosis:In Brate group,4 patients(26.6%)reached complete remission,6 patients(40.0%)reached partial remission,2 patients(13.3%)did not improve or deteriorate,and 2 patients(13.3%)presented with a doubling of serum creatinine,1 patient(6.6%)developed to end-stage renal disease;In control group,1 patient(6.6%)reached partial remission(PR),3 patients(20.0%)remained stable,and 6 patients(40.0%)presented with a doubling of serum creatinine,and 5 patients(33.3%)developed to end stage renal disease.After 2 years of follow-up,patients in brate group showed superior survival and stable renal function(P<0.05).Conclusion:Fenofibrate can induce remission of lipoprotein glomerulopathy and decelerate the progress of renal insufficiency.