Comparison of antiproteinuric effects of two different combination therapies in children with IgA nephropathy.

Abstract

BACKGROUND:

Because moderate or severe proteinuria is a representative factor indicative of longterm poor prognosis in IgA nephrology, an anti-proteinuric treatment which can be administered longterm with few side effects is necessary. We report here a comparison of antiproteinuric effects in two patient groups treated with different combination therapies.

METHODS:

Group A comprised 12 patients with IgA nephropathy, who had 24-h proteinuria of 0.5 gm(2) or more, moderately severe renal histology, and normal renal function, and were treated with a combination of drugs, i.e., prednisolone, an immunosuppressant (mizoribine), an anti-platelet drug (dipyridamole), and an angiotensin-converting enzyme inhibitor. Group B consisted of 18 patients who had baseline characteristics similar to those of the patients in group A and were treated with our previous protocol (a combination of prednisolone, cyclophosphamide, and dipyridamole). Twenty-four-hour proteinuria and creatinine clearance were measured every 6 months. The primary endpoint was reduction of 24-h proteinuria by less than 25% compared with the baseline value.

RESULTS:

The proportion of patients that exhibited the primary endpoint, as assessed by the Kaplan-Meier method, was found to be significantly higher in group A than in group B (logrank test; P = 0.024). None of the patients in the two groups experienced serious adverse effects.

CONCLUSIONS:

The results suggested that the use of drugs in combination with cyclophosphamide was beneficial for patients with moderately severe IgA nephropathy. Because moderate or severe proteinuria is a representative factor indicative of longterm poor prognosis in IgA nephropathy, an anti-proteinuric treatment which can be administered longterm with few side effects is necessary. We report here a comparison of antiproteinuric effects in two patient groups treated with different combination therapies.

• Authors: Kazuro Yagi, Mitsuru Okada, Hidehiko Yanagida, Hiroaki Kuwajima, Masaru Ikeda, Keisuke Sugimoto, Tsukasa Takemura
• Journal: Clinical and experimental nephrology (Clin Exp Nephrol) Vol. 7 Issue 4 Pg. 270-4 (Dec 2003) ISSN: 1342-1751 [Print] Japan
• PMID: 14712355 (Publication Type: Clinical Trial, Comparative Study, Journal Article)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Anti-Inflammatory Agents
• Immunosuppressive Agents
• Ribonucleosides
• Vasodilator Agents
• mizoribine
• Dipyridamole
• Prednisone

Topics

• Adolescent
• Adult
• Age of Onset
• Angiotensin-Converting Enzyme Inhibitors (adverse effects, therapeutic use)
• Anti-Inflammatory Agents (adverse effects, therapeutic use)
• Child
• Child, Preschool
• Dipyridamole (adverse effects, therapeutic use)
• Drug Therapy, Combination
• Female
• Glomerulonephritis, IGA (complications, drug therapy, pathology)
• Humans
• Immunosuppressive Agents (adverse effects, therapeutic use)
• Kidney (pathology)
• Male
• Prednisone (adverse effects, therapeutic use)
• Proteinuria (drug therapy, etiology)
• Ribonucleosides (adverse effects, therapeutic use)
• Treatment Outcome
• Vasodilator Agents (adverse effects, therapeutic use)