Effects of Spironolactone on the Urinary Excretion of TGF-beta1 in IgA Nephropathy.
- Author:
Kyung Hwan JEONG
1
;
Mina PARK
;
Joo Young MOON
;
Sang Ho LEE
;
Tae Won LEE
;
Chun Gyoo IHM
Author Information
1. Department of internal medicine, College of Medicine, Kyung Hee University. cgihm@yahoo.ac.kr
- Publication Type:Original Article
- Keywords:
Glomerulonephritis;
IgA;
Transforming growth factor beta 1;
Spironolactone
- MeSH:
Aldosterone;
Creatinine;
Enzyme-Linked Immunosorbent Assay;
Extracellular Matrix;
Glomerulonephritis;
Glomerulonephritis, IGA*;
Humans;
Immunoglobulin A*;
Losartan;
Prednisolone;
Proteinuria;
Spironolactone*;
Transforming Growth Factor beta1*
- From:Korean Journal of Nephrology
2007;26(5):541-547
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Transforming growth factor-beta1 (TGF-beta1) has an important role in the pathogenesis of renal damage; it enhances extracellular matrix production. Urinary TGF-beta1 excretion has been shown to be significantly increased in patients with IgA nephropathy. The aim of the present study was to evaluate the effect of spironolactone on urinary TGF-beta1 levels in patients with IgA nephropathy. METHODS: TGF-beta1 was measured by enzyme-linked immunosorbent assay in random urine specimens from 35 patients with IgA nephropathy. The patients were assigned to a spironolactone group, prednisolone group or losartan group. They were treated over an 8-week period. Urine samples were tested at the beginning and the end of the treatment period. RESULTS: The patients with IgA nephropathy (n=35) had a higher urinary excretion of TGF-beta1 than normal controls (n=13). Urinary TGF-beta1 excretion was positively correlated with proteinuria and pathological grading but not with serum creatinine. After 8 weeks of treatment, losartan (n=13) and prednisolone (n=11) therapy induced a significant reduction in both urinary protein and TGF-beta1 excretion. After treatment with spironolactone (n=11), urinary protein and TGF-beta1 excretion were decreased. However, the decrease was not statistically significant. There was a significant correlation between the urinary TGF-beta1 excretion and the serum aldosterone (r=0.84; p<0.01); however, treatment with spironolactone abolished this correlation. CONCLUSION: This study provides evidence that endogenous aldosterone influences urinary TGF-beta1 excretion in patients with IgA nephropathy.
