| Theme |
Dialysis in Diabetic Patients |
| Title |
LDL apheresis applied to ASO patients with diabetic gangrene |
| Author |
Kazushige Hanaoka |
Division of Internal Medicine, Kanagawa Prefectural Hospital Affiliated with Nurses Training School |
| Author |
Yoshindo Kawaguchi |
Division of Internal Medicine, Kanagawa Prefectural Hospital Affiliated with Nurses Training School / Jikei University School of Medicine |
| [ Summary ] |
Diabetes mellitus is the most significant risk factor for developing arteriosclerotic obliterans (ASO). It is very difficult to treat once diabetic patients with chronic renal failure develop infectious gangrenes. Recently, low-density lipoprotein (LDL) apheresis has been used for severe ASO patients with diabetic gangrene. More than half of the cases treated with LDL apheresis showed improvements in clinical symptoms. Possible mechanisms to explain why LDL apheresis successfully improves impaired peripheral circulation and cures cutaneous ulcers could be that it not only reduces serum LDL levels but also suppresses chronic inflammation in small vessels.
Here in we briefly review the indications for and practical guide lines for LDL apheresis for ASO patients with diabetic gangrene according to our clinical experience with reduction of serum high-sensitive C reactive proteins, as well as serum LDL levels upto 50 % of original level. |