Retrospective Comparisons about Effects of Angiotensin II Receptor Blocker and/or Steroid on Proteinuria Reduction and Renal Protection in IgA Nephropathy Patients with Proteinuria less than 1 g/g.
- Author:
Seung Joon HWANG
1
;
So Young CHOI
;
Sung Yeon CHO
;
Ji Young PARK
;
Kyung Hwan JUNG
;
Joo Yung MOON
;
Sang Ho LEE
;
Tae Won LEE
;
Chun Gyoo IHM
Author Information
1. Division of Nephrology, Department of Internal Medicine, College of Medicine Kyung Hee University, Seoul, Korea. cgihm@yahoo.co.kr
- Publication Type:Original Article
- Keywords:
Glomerulonephritis;
IgA;
Angiotensin II type 1 receptor blockers;
Prednisolone;
Proteinuria
- MeSH:
Angiotensin II;
Angiotensin II Type 1 Receptor Blockers;
Angiotensins;
Antihypertensive Agents;
Biphenyl Compounds;
Creatinine;
Follow-Up Studies;
Glomerulonephritis;
Glomerulonephritis, IGA;
Humans;
Immunoglobulin A;
Losartan;
Polymerase Chain Reaction;
Prednisolone;
Proteinuria;
Receptors, Angiotensin;
Retrospective Studies;
Tetrazoles;
Valine;
Valsartan
- From:Korean Journal of Nephrology
2009;28(6):579-587
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: It remains controversial how to treat the IgA nephropathy (IgAN) patients with proteinuria <1g/day. We investigated effects of single or combined use of angiotensin II receptor blocker (ARB) and steroid on proteinuria reduction and renal protection in IgAN patients with normal renal function and urine protein/creatinine ratio (PCR) < or =1 g/g. METHODS: Oral prednisolone was given at an initial dose of 1 mg/kg every day for 2 months and then gradually tapered for 4 months. An ARB irbesartan or losartan or valsartan was given until the end of follow-up. RESULTS: Over a mean follow-up period of about 40 mo, the urine PCR decreased from 0.64+/-0.29 g/g to 0.32+/-0.31 g/g in the combination group (n=26) (p<0.05). But in ARB (n=17) and steroid groups (n=20), it decreased from 0.56+/-0.26 g/g to 0.54+/-0.45 g/g and from 0.50+/-0.26 g/g to 0.34+/-0.32 g/g, respectively, while there were no statistical significances. Serum creatinine decreased from 0.83+/-0.13 mg/dL to 0.73+/-0.14 mg/dL in steroid group (p<0.01), and from 0.92+/-0.17 mg/dL to 0.81+/-0.23 mg/dL in combination group (p<0.01). But in ARB group, no statistical significance was noticed. All patients achieved the BP goal < or =130/80 mmHg by adding anti-hypertensive drugs, if necessary. CONCLUSION: Our results indicate that (steroid or) combination therapy reduced proteinuria and improved renal function in the patients with proteinuria < or =1 g/g. Further prospective controlled studies are required to clarify the effect of steroid over the long term.
