Probucol for treatment of hyperlipidemia in persistent childhood nephroticsyndrome - Report of a prospective uncontrolled multicenter study

In a prospective, uncontrolled multicenter study, we have evaluated the eff ects of probucol on hyperlipidemia, proteinuria, and glomerular filtration rate (GFR) in hyperlipidemic children with persistent nephrotic syndrome. P robucol was started for a total of 12 weeks in 8 children and for 24 weeks in 14 children. Lipoprotein profiles, serum malondialdehyde (MDA) levels, p roteinuria, renal function, and electrocardiogram were monitored every 4 we eks. Side effects were recorded by questionnaire. Treatment was completed b y 7 of 8 patients for 12 weeks and by 7 of 14 children for 24 weeks. After 12 weeks, the mean serum concentrations of triglycerides (-15%), total chol esterol (-25%), very low-density lipoprotein-cholesterol (-27%), low-densit y lipoprotein-cholesterol (-23%), and high-density lipoprotein-cholesterol (-24%), as well as apolipoprotein (apo) A-I (-19%), apo B (-21%), and MDA ( -32%) were reduced. The positive effects of probucol on the lipoprotein pro file persisted over 24 weeks; however, there was no significant effect on e ither proteinuria or GFR. In conclusion, probucol had beneficial effects on lipoproteins and lipid peroxidation, but improved neither proteinuria nor GFR. The drug was generally tolerated well, but had to be discontinued beca use of a prolonged QT interval in 4 of 22 patients.