Document Detail


Renin-angiotensin system inhibitors reduce the progression of mesangioproliferative glomerulonephritis: 10 year follow-up.
MedLine Citation:
PMID:  22075320     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Proteinuria is a common presentation of mesangioproliferative glomerulonephritis (MsPGN). No studies are available on the long-term effect of treatment by renin-angiotensin system (RAS) inhibitors on renal outcome in MsPGN patients. This study prospectively evaluates the effects of RAS inhibitors on renal outcome in patients with low risk MsPGN followed up for 10 years using historical patients with similar features at the time of presentation as untreated controls.
METHODS:
ENDPOINTS: decrease of basal proteinuria>20% and loss>20% of basal glomerular filtrate rate (GFR) at the end of first year of observation. The patients were re-evaluated bimonthly during the first year and every 6 months thereafter.
RESULTS: Twenty-five patients fulfilled the selection criteria. After one year follow-up 19 patients reached the endpoint of proteinuria and no patient reached the endpoint of GFR. No significant change in blood pressure levels (BP) and GFR was registered, by contrast daily proteinuria decreased significantly (p<0.001), falling by 29% at sixth month and 47% at the end of the follow-up. The historical control group consisted of 15 untreated patients seen between 1987 and 1992. The two-way analysis of variance for repeated measures showed greater values of GFR (p<0.001) and lower levels of daily proteinuria (p<0.001) in treated patients as compared to untreated controls.
CONCLUSIONS: This 10-year follow-up study indicates that the early treatment with RAS inhibitors at low doses favourably influences the long-term renal outcome in proteinuric patients with MsPGN. Limitations were the small sample size and lack of randomization.
Authors:
Pierangela Presta; Roberto Minutolo; Carmela Iodice; Nicola Comi; Vincenzo Casoria; Laura Fuiano; Chiara Caglioti; Giuseppe Conte; Giorgio Fuiano
Publication Detail:
Type:  Controlled Clinical Trial; Journal Article     Date:  2011-09-28
Journal Detail:
Title:  European journal of internal medicine     Volume:  22     ISSN:  1879-0828     ISO Abbreviation:  Eur. J. Intern. Med.     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-14     Completed Date:  2012-03-09     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  9003220     Medline TA:  Eur J Intern Med     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  e90-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT01115426
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MeSH Terms
Descriptor/Qualifier:
Adult
Angiotensin II Type 1 Receptor Blockers / administration & dosage,  adverse effects
Angiotensin-Converting Enzyme Inhibitors / administration & dosage,  adverse effects
Biopsy
Disease Progression
Evidence-Based Medicine
Follow-Up Studies
Glomerular Filtration Rate
Glomerulonephritis, Membranoproliferative / drug therapy*,  pathology
Humans
Losartan / administration & dosage*,  adverse effects
Prospective Studies
Proteinuria / drug therapy,  pathology
Ramipril / administration & dosage*,  adverse effects
Renin-Angiotensin System / drug effects*
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; JMS50MPO89/Losartan; L35JN3I7SJ/Ramipril

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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