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Effects of combination therapy with Renin-Angiotensin system inhibitors and eicosapentaenoic Acid on IgA nephropathy.
MedLine Citation:
PMID:  23318848     Owner:  NLM     Status:  In-Data-Review    
Objective The beneficial effects of renin-angiotensin-aldosterone system inhibitors (RASI) and the omega-3 polyunsaturated fatty acid eicosapentaenoic acid (EPA) on IgA nephropathy (IgAN) have been reported. However, it is unknown whether these agents have any synergistic interactions. Methods We divided 38 IgAN patients into two groups: an EPA group (n=18) treated with RASI plus EPA and a DILAZEP group (n=20) treated with RASI plus dilazep dihydrochloride. We analyzed the clinical and histological background of each patient, any relevant clinical findings obtained one year after treatment and any factors significantly related to decreases in proteinuria. Results The clinical findings were largely similar between the groups, except for body mass index (24.9±4.5 in the EPA group vs. 21.4±2.1 in the DILAZEP group, p=0.0041) and total cholesterol (median: 206.0 vs. 177.5 mg/dL, p=0.0493). The histological findings, evaluated according to the Oxford classification, were also similar between the groups. At one year after treatment, the EPA group demonstrated a significantly decreased mean blood pressure (from 94.7±9.0 to 86.4±7.2 mmHg, p=0.0007) and a significantly decreased median level of proteinuria (from 0.80 to 0.41 g/g creatinine, p<0.001). In the DILAZEP group, the mean blood pressure significantly decreased (from 95.2±13.2 to 88.1±7.7 mmHg, p<0.001) without any significant decrease in the median level of proteinuria (from 0.88 to 0.60 g/g creatinine). According to a multivariate logistic analysis, EPA was found to be the only independent factor related to decreases in proteinuria (odds ratio = 5.073, 95% CI: 1.18-26.7, p=0.0285). Conclusion We conclude that EPA accelerates the effects of RASI and thus decreases the proteinuria observed in patients with IgAN.
Takahito Moriyama; Chihiro Iwasaki; Kayu Tanaka; Ayami Ochi; Ari Shimizu; Syunji Shiohira; Mitsuyo Itabashi; Takashi Takei; Keiko Uchida; Ken Tsuchiya; Kosaku Nitta
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Publication Detail:
Type:  Journal Article     Date:  2013-01-15
Journal Detail:
Title:  Internal medicine (Tokyo, Japan)     Volume:  52     ISSN:  1349-7235     ISO Abbreviation:  Intern. Med.     Publication Date:  2013  
Date Detail:
Created Date:  2013-01-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204241     Medline TA:  Intern Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  193-9     Citation Subset:  IM    
Department of Medicine, Kidney Center, Tokyo Women's Medical University, Japan.
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