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Renoprotective efficacy of valsartan in chronic nondiabetic proteinuric nephropathies with renin-angiotensin system gene polymorphisms.
MedLine Citation:
PMID:  21303424     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aim:  The renoprotective effects of angiotensin receptor blockers vary considerably among individuals. We investigated the renoprotective effects of valsartan according to polymorphisms of the renin-angiotensin system and transforming growth factor-b(1) (TGFB1) genes in patients with chronic nondiabetic proteinuric nephropathies. Methods:  Two hundred thirty-nine nondiabetic patients with proteinuria of at least 1 g per day were enrolled. Patients received 80mg of valsartan daily, followed by 160 mg daily after six weeks. The follow-up period was 18 months. The status of the angiotensin converting enzyme (ACE) insertion/deletion, angiotensinogen (AGT) M235T, type 1 angiotensin II receptor (ATR1) A1166C, and TGFB1 C509 and T869C polymorphisms was determined in 162 patients. Results:  Valsartan treatment caused a significant reduction in proteinuria from baseline throughout the study in patients with each genotype of the ACE, AGT and TGFB1 genes. However, patients with the ATR1 AC genotype had no significant reduction in proteinuria from baseline throughout the study course. The median reductions in proteinuria after six months were 45.7% and 10.8% in the patients with the ATR1 AA and AC genotypes, respectively (P= 0.034). The annual change in the estimated glomerular filtration rate did not differ significantly among the genotypes for each gene. On multiple regression analysis, the change in proteinuria after six months of treatment was independently associated with the ATR1 genotype and the change in blood pressure (P = 0.005 and 0.019, respectively). Conclusion:  Valsartan treatment significantly reduced the blood pressure and urinary protein excretion of patients with chronic nondiabetic proteinuric nephropathies. Interindividual differences in the antiproteinuric effect of valsartan may be related partly to the ATR1 A1166C polymorphism.
Authors:
Yu-Ji Lee; Hye Ryoun Jang; Seong Gyun Kim; Dong-Wan Chae; Jun-Young Do; Jung Eun Lee; Wooseong Huh; Dae Joong Kim; Ha Young Oh; Yoon-Goo Kim
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-8
Journal Detail:
Title:  Nephrology (Carlton, Vic.)     Volume:  -     ISSN:  1440-1797     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9615568     Medline TA:  Nephrology (Carlton)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. Nephrology © 2011 Asian Pacific Society of Nephrology.
Affiliation:
Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Internal Medicine and Kidney Research Institute, Hallym University College of Medicine, Anyang, Korea Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea.
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