| Treatment of Early Immunoglobulin A Nephropathy by Angiotensin-converting Enzyme Inhibitor. | |
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MedLine Citation:
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PMID: 23331443 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: The treatment of immunoglobulin A (IgA) nephropathy with normal renal function and minimal proteinuria is unknown. METHODS: We randomly assigned 60 patients with IgA nephropathy, proteinuria <0.5 g/day, normal blood pressure and renal function to ramipril 2.5 mg daily or no treatment. Patients were followed for 5 years for the development of hypertension, proteinuria, or impaired renal function. RESULTS: The blood pressure of the treatment group was marginally lower than the control group throughout the study period. At 60 months, the event-free survival was marginally higher for the treatment group as compared with the control group (81.1% vs 70.5%, P=.27). The proteinuria-free survival was similar at 82.9% and 79.3% for the treatment and control groups, respectively (P=.6); hypertension-free survival was 86.4% and 79.3% (P=.2). After 60 months of follow-up, the estimated glomerular filtration rate (GFR) was 108.1±29.0 mL/min/1.73 m(2) for the treatment group and 105.7±17.7 mL/min/1.73 m(2) for the control group (P=.7), but the difference was not statistically significant. None of the patients developed impaired renal function. The rate of GFR decline was similar between the treatment and control groups (-0.39±2.57 vs -0.59±1.63 mL/min/1.73 m(2) per year, respectively, P=.7). In general, the study medication was well tolerated. Two patients needed to stop prematurely because of cough and dizziness. CONCLUSION: For early IgA nephropathy patients with minimal proteinuria, normal blood pressure, and normal renal function, treatment with 2.5 mg/daily of ramipril for 5 years does not offer any benefit. |
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Authors:
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Philip Kam-Tao Li; Bonnie Ching-Ha Kwan; Kai-Ming Chow; Chi-Bon Leung; Cheuk-Chun Szeto |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of medicine Volume: 126 ISSN: 1555-7162 ISO Abbreviation: Am. J. Med. Publication Date: 2013 Feb |
Date Detail:
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Created Date: 2013-01-21 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0267200 Medline TA: Am J Med Country: United States |
Other Details:
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Languages: eng Pagination: 162-8 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2013 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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