Vitamin E therapy in IgA nephropathy: a double-blind, placebo-controlled study.

Abstract

IgA nephropathy is the world's most common primary glomerulonephropathy. Recent evidence in a rat model implicated excessive production of oxygen-free radicals in the pathogenesis and suggested that vitamin E-treatment ameliorated progression. We studied this antioxidant therapy on the glomerular filtration rate (GFR), proteinuria and hematuria in biopsy-proven IgA nephropathy in children. The duration of treatment or placebo was 2 years, with vitamin E treatment consisting of 400 IU/day in children weighing <30 kg, and twice that dose for those >30 kg. We measured GFR at entry, midpoint and exit. At baseline and at 4-month intervals after randomization, urinary protein/creatinine ratios and urinalysis were examined. The mixed model procedure with log transformation was used in data analysis to test treatment difference as well as the potential time effect. Fifty-five patients were randomized and 38 completed at least 1 year of follow-up. At entry, the clinical characteristics were not different between the treatment and placebo groups. There was a trend toward better preservation of GFR in vitamin E-treated versus placebo patients, 127+/-50 vs. 112+/-31 ml/min/1.73 m(2), respectively ( P=0.09). The urinary protein/creatinine ratio was significantly lower in the vitamin E-treated group vs. placebo; 0.24+/-0.38 vs. 0.61+/-1.37 ( P<0.013). However, there was no difference in the prevalence of hematuria between the groups. Vitamin E treatment in our study patients was associated with significantly lower proteinuria, but no effect on hematuria. While there was a trend toward stabilization of GFR in the vitamin E-treated patients, long-term treatment and follow-up are needed to determine whether antioxidant therapy is associated with preservation of renal function in IgA nephropathy.

• Authors: James C M Chan, John D Mahan, Howard Trachtman, Jon Scheinman, Joseph T Flynn, Uri S Alon, Marc B Lande, Robert A Weiss, Edward P Norkus
• Journal: Pediatric nephrology (Berlin, Germany) (Pediatr Nephrol) Vol. 18 Issue 10 Pg. 1015-9 (Oct 2003) ISSN: 0931-041X [Print] Germany
• PMID: 12920628 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Antioxidants
• Placebos
• Vitamin E

Topics

• Adolescent
• Antioxidants (administration & dosage)
• Child
• Double-Blind Method
• Female
• Glomerular Filtration Rate (drug effects)
• Glomerulonephritis, IGA (drug therapy)
• Humans
• Male
• Pilot Projects
• Placebos
• Prospective Studies
• Proteinuria (drug therapy)
• Treatment Outcome
• Vitamin E (administration & dosage)