We report a patient with
IgA nephropathy (IgAN) showing reduction of
proteinuria and histological improvement of renal injury with
cyclosporin A (CsA) and
angiotensin-II receptor blocker (ARB)
therapy. The amount of urinary
protein was reduced from 4.4 to 1.8 g/24 h after 2 months of CsA (150 mg/day)
therapy, and further, to 0.4 g/24 h after 1 month of the combination
therapy with ARB (
candesartan, 4 mg/day). A renal re-biopsy,
after treatment with CsA for 3 months and ARB for 1 month, demonstrated a reduction of
IgA deposits, disappearance of crescents, re-separation of foot process fusion and decrease of interstitial cellular infiltration. After CsA
therapy for 20 months and ARB for 18 months, the patient currently remains stable without deterioration of serum
creatinine (1.7 mg/dl) and urinary
protein excretion (0.5 g/day). These findings seem to indicate that combination
therapy with CsA and ARB is effective for achieving histological improvement and protecting against deteriorated renal function, in addition to reducing
proteinuria, in IgAN.