Effect of Combined Treatment of Steroid and Angiotensin II Receptor Blocker (ARB) in Proteinuric IgA Nephropathy.
- Author:
Sang Hoon LEE
1
;
Jae Jun SHIM
;
Sang Ho LEE
;
Tae Won LEE
;
Myung Jae KIM
;
Moon Ho YANG
;
Chun Gyoo IHM
Author Information
1. Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea. cgihm@yahoo.co.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Angiotensin II receptor blocker;
Prednisolone;
IgA nephropathy;
Proteinuria;
Renal function
- MeSH:
Adult;
Angiotensin II*;
Angiotensins*;
Follow-Up Studies;
Glomerulonephritis, IGA*;
Humans;
Immunoglobulin A*;
Prednisolone;
Prospective Studies;
Proteinuria;
Receptors, Angiotensin*
- From:Korean Journal of Nephrology
2003;22(5):539-545
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: It has been reported that prednisolone (PDL) therapy favorably influences proteinuria and renal function in the patients with IgAN in whom ARB as well as ACE inhibitor has an anti- proteinuric effect. Therefore, we did a controlled prospective trial to test the effect of treatment with PDL (daily high-dose for 6 months) and ARB in proteinuric adult patients with IgAN. METHODS: Forty-two patients with proteinuria > or =1.0 g/day and serum Cr < or =2.0 mg/dL were randomized to treatment with PDL and ARB and to that with ARB alone. RESULTS: The follow-up period lasted 15.4+/-3.5 months in combination group (n=18) and 19.8+/-7.4 months in ARB group (n=20). Proteinuria was significantly reduced in the both groups (ARB group: from 4.31+/-2.85 g to 1.38+/-1.09 g vs. combination group: from 4.67+/-5.33g to 0.78+/-0.99 g). The rate of complete remission was 10% in ARB group and 44% in combination group at the final follow-up (p<0.05). There were no differences of mean serum Cr between groups before and after treatment. The number of patient with aggravation in renal function was five (25%) in ARB group and one (5%) in combination group. CONCLUSION: This study shows that the urinary protein excretion was effectively reduced by both groups and the rate of complete remission was higher in combination group than in ARB group. Long- term follow-up may be helpful to define the effect on the renal function in IgAN patients.
