Beneficial effects of olmesartan and temocapril on urinary liver-type fatty acid-binding protein levels in normotensive patients with immunoglobin A nephropathy.

Abstract

BACKGROUND:

Liver-type fatty acid-binding protein (L-FABP) is a clinical biomarker of tubulointerstitial damage, which plays an essential role in the progression of chronic kidney disease (CKD), including immunoglobin A (IgA) nephropathy. The effect of combination therapy with the angiotensin receptor blocker (ARB) and the angiotensin-converting enzyme inhibitor (ACEI) on CKD has not been elucidated.

METHODS:

Twenty-four normotensive patients with IgA nephropathy were randomly assigned to receive olmesartan 10 mg/day, temocapril 2 mg/day, or combination therapy with both drugs. Urinary levels of L-FABP as well as 8-hydroxydeoxyguanosine (8-OHdG) and protein excretion were measured before and after 3 months of treatment. The chronicity index and activity index were also assessed by histopathologic findings.

RESULTS:

Urinary levels of L-FABP and 8-OHdG were higher in patients with IgA nephropathy than in age-matched and sex-matched healthy controls (122.5 +/- 25.5 v 6.4 +/- 3.8 mug/g.creatinine, P < .001; and 22.6 +/- 4.4 v 4.8 +/- 1.4 ng/mg.creatinine, P < .01, respectively). Urinary levels of L-FABP were correlated with those of 8-OHdG (baseline, P = .0001; after 3 months, P = .008) and the severity of proteinuria (baseline, P = .0015; after 3 months, P = .0001). The percent reductions in urinary levels of L-FABP and 8-OHdG, protein excretion, and activity index after 3 months were greater in the combination therapy group, compared with each monotherapy group of olmesartan (P < .05) and temocapril (P < .05).

CONCLUSIONS:

The data suggest that a combination therapy of ARB plus ACEI has a greater beneficial effect on renal injury compared with monotherapy using ARB or ACEI in normotensive patients with IgA nephropathy.

• Authors: Tsukasa Nakamura, Teruo Inoue, Takeshi Sugaya, Yasuhiro Kawagoe, Tsukasa Suzuki, Yoshihiko Ueda, Hikaru Koide, Koichi Node
• Journal: American journal of hypertension (Am J Hypertens) Vol. 20 Issue 11 Pg. 1195-201 (Nov 2007) ISSN: 0895-7061 [Print] United States
• PMID: 17954367 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Angiotensin II Type 1 Receptor Blockers
• Angiotensin-Converting Enzyme Inhibitors
• Fatty Acid-Binding Proteins
• Imidazoles
• Tetrazoles
• Thiazepines
• 8-Hydroxy-2'-Deoxyguanosine
• temocapril hydrochloride
• olmesartan
• Deoxyguanosine

Topics

• 8-Hydroxy-2'-Deoxyguanosine
• Adult
• Angiotensin II Type 1 Receptor Blockers (therapeutic use)
• Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
• Blood Pressure (physiology)
• Deoxyguanosine (analogs & derivatives, urine)
• Double-Blind Method
• Drug Therapy, Combination
• Fatty Acid-Binding Proteins (urine)
• Female
• Glomerulonephritis, IGA (drug therapy, physiopathology, urine)
• Heart Rate (physiology)
• Humans
• Imidazoles (therapeutic use)
• Male
• Proteinuria (prevention & control)
• Tetrazoles (therapeutic use)
• Thiazepines (therapeutic use)