Korean J Nephrol.  2003 Sep;22(5):539-545.

Effect of Combined Treatment of Steroid and Angiotensin II Receptor Blocker (ARB) in Proteinuric IgA Nephropathy

• Lee SH
• Shim JJ
• Lee SH
• Lee TW
• Kim MJ
• Yang MH
• Ihm CG

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.

Keyword

Angiotensin II receptor blocker; Prednisolone; IgA nephropathy; Proteinuria; Renal function

MeSH Terms

Adult
Angiotensin II*
Angiotensins*
Follow-Up Studies
Glomerulonephritis, IGA*
Humans
Immunoglobulin A*
Prednisolone
Prospective Studies
Proteinuria
Receptors, Angiotensin*
Angiotensin II
Angiotensins
Immunoglobulin A
Prednisolone
Receptors, Angiotensin