Korean J Intern Med.
2016 Mar;31(2):335-343. 10.3904/kjim.2014.266.
Effect of low-dose valsartan on proteinuria in normotensive immunoglobulin A nephropathy with minimal proteinuria: a randomized trial
- Affiliations
-
- 1Division of Nephrology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.
- 2BK-21, Konkuk University School of Medicine, Seoul, Korea.
- 3Division of Nephrology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
- 4Division of Nephrology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea.
- 5Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
- 6Division of Nephrology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
- 7Department of Pathology, Konkuk University Medical Center, Seoul, Korea.
- 8Department of Pathology, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
- 9Division of Nephrology, Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea. sskyun@hotmail.com
- KMID: 2373809
- DOI: http://doi.org/10.3904/kjim.2014.266
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.
Keyword
MeSH Terms
-
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
Angiotensin II Type 1 Receptor Blockers
Biomarkers
Creatinine
Valsartan
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