Medication Can Spare Harm to Kidney

Tuesday, October 17th 2000, 12:00 am
By: News On 6

The kidney disease diagnosed in NBA star Alonzo Mourning frequently leads to dialysis or a transplant, as it did with San Antonio Spurs forward Sean Elliott. But with medication, Mourning may avoid that fate.

He has a good doctor, and now he needs ``a little bit of luck,'' said kidney specialist Dr. Leonard Stern of the Columbia Presbyterian Medical Center in New York.

The disease, which experts called relatively uncommon, is focal glomerulosclerosis (gloh-MARE-yoo-loh-skleh-ROH-sis). Symptoms can include swelling in the legs, as in Mourning's case, and high rates of protein in urine and high cholesterol in the blood.

The disease attacks the tiny filters in the kidney that remove waste from the blood. That makes the kidney spill protein from blood into the urine. The resulting kidney damage can lead to kidney failure, which requires dialysis or a transplant. Elliott rejoined his team in March after getting a new kidney from his brother.

The illness appears in children and adults, with most adult cases developing between ages 15 and 30. ``No age group is spared, no race is spared,'' said Dr. Brian Pereira, president-elect of the National Kidney Foundation.

Some forms may be more common in blacks, but the statistics aren't clear, Stern said.

Neither expert was involved in treating Mourning.

In most cases, the cause of focal glomerulosclerosis is not known. And while medication can slow the progression of the disease, most patients do eventually need dialysis or transplant, Pereira said.

But Stern emphasized that some patients can avoid that fate. The goal of treament is to reduce or eliminate the leakage of protein into the urine, he said.

The usual strategy is to use medications for a year or two to control blood pressure, cholesterol levels and the protein leakage, and to suppress the immune system, which appears to play a role in the disease, Stern said.

If the patient tolerates the drug regimen and the protein leakage stops, that indicates a remission. If that can be sustained, the prognosis is good, Stern said.

The hope is that with treatment, the disease will ``burn itself out'' so that the medications can be stopped, he said.