Effect of low-dose valsartan on proteinuria in normotensive immunoglobulin A nephropathy with minimal proteinuria: a randomized trial.
- Author:
Young Il JO
1
;
Ha Young NA
;
Ju Young MOON
;
Sang Woong HAN
;
Dong Ho YANG
;
Sang Ho LEE
;
Hyeong Cheon PARK
;
Hoon Young CHOI
;
So Dug LIM
;
Jeong Hae KIE
;
Yong Kyu LEE
;
Sug Kyun SHIN
Author Information
- Publication Type:Multicenter Study ; Original Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
- Keywords: Angiotensin receptor antagonists; Glomerulonephritis, IGA; Proteinuria; Safety; Treatment outcome
- MeSH: Adult; Angiotensin II Type 1 Receptor Blockers/*administration & dosage/adverse effects; Biomarkers/urine; Blood Pressure; Creatinine/urine; Female; Glomerulonephritis, IGA/diagnosis/*drug therapy/physiopathology/urine; Humans; Male; Middle Aged; Prospective Studies; Proteinuria/diagnosis/*drug therapy/physiopathology/urine; Republic of Korea; Time Factors; Treatment Outcome; Valsartan/*administration & dosage/adverse effects
- From:The Korean Journal of Internal Medicine 2016;31(2):335-343
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Immunoglobulin A nephropathy (IgAN) is a generally progressive disease, even in patients with favorable prognostic features. In this study, we aimed to investigate the antiproteinuric effect and tolerability of low-dose valsartan (an angiotensin II receptor blocker) therapy in normotensive IgAN patients with minimal proteinuria of less than 0.5 to 1.0 g/day. METHODS: Normotensive IgAN patients, who had persistent proteinuria with a spot urine protein-to-creatinine ratio of 0.3 to 1.0 mg/mg creatinine, were recruited from five hospitals and randomly assigned to either 40 mg of valsartan as the low-dose group or 80 mg of valsartan as the regular-dose group. Clinical and laboratory data were collected at baseline, and at 4, 8, 12, and 24 weeks after valsartan therapy. RESULTS: Forty-three patients (low-dose group, n = 23; regular-dose group, n = 20) were enrolled in the study. Proteinuria decreased significantly not only in the regular-dose group but also in the low-dose group. The change in urine protein-to-creatinine ratio at week 24 was -41.3% +/- 26.1% (p < 0.001) in the regular-dose group and -21.1% +/- 45.1% (p = 0.005) in the low-dose group. In the low-dose group, blood pressure was constant throughout the study period, and there was no symptomatic hypotension. In the regular-dose group, blood pressure decreased at weeks 8 and 12. No significant change in glomerular filtration rate, serum creatinine level, or serum potassium level was observed during the study period. CONCLUSIONS: Our results suggest that low-dose valsartan can significantly reduce proteinuria without causing any intolerability in normotensive IgAN patients with minimal proteinuria.
