title: Antioxidant treatment of therapy-resistant idiopathic membranous nephropathy with probucol: a pilot study.
abstract: BACKGROUND
  Proteinuria in Heymann's nephritis, an experimental rat model disease corresponding to membranous nephropathy, has been shown to be due to lipid peroxidation. Since the pathophysiology might be similar to idiopathic membranous nephropathy in humans, we performed a prospective multicenter trial to investigate the efficacy of the lipid peroxidation scavenger, probucol.
  
  
  METHODS
  Fifteen patients with biopsy-proven idiopathic membranous nephropathy resistant to conventional immunosuppressive therapy (n = 7) and/or ACEI treatment (n = 12) were recruited. Probucol (1 g/d orally) was administered for three months, followed by a washout period of four weeks, whereon lovastatin (10-20 mg/d orally) was administered for additional three months.
  
  
  RESULTS
  A significant reduction in proteinuria was seen during the probucol treatment (median (range): 6.4 (3.8-9.1) g/d vs. 4.7 (1.3-16) g/d; P < 0.05), with partial remission achieved in four patients. Three of these patients had previously been resistant to immunosuppressive therapy. Median protein excretion increased to pretreatment values during the washout period (6.2 (1.9-15) g/d; P < 0.05) and was not significantly different after the intake of lovastatin (4.9 (1.8-19) g/d; P = NS). None of the patients achieved partial remission during lovastatin therapy (P < 0.05 vs. probucol).
  
  
  CONCLUSIONS
  The present study led us to conclude that proteinuria can be reduced by probucol in some patients with idiopathic membranous nephropathy. A randomized multicenter study to further elucidate the influence of lipid peroxidation scavengers on membranous nephropathy is warranted.
authors.affiliation: Division of Nephrology and Dialysis, University of Vienna, Austria. Martin.Haas@akh-wien.ac.at
authors.forename: Martin
authors.initials: M
authors.lastname: Haas
authors.forename: Gert
authors.initials: G
authors.lastname: Mayer
authors.forename: Gerhard
authors.initials: G
authors.lastname: Wirnsberger
authors.forename: Herwig
authors.initials: H
authors.lastname: Holzer
authors.forename: Manfred
authors.initials: M
authors.lastname: Ratschek
authors.forename: Ullrich
authors.initials: U
authors.lastname: Neyer
authors.forename: Josef
authors.initials: J
authors.lastname: Neuweiler
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kramar
authors.forename: Brigitte
authors.initials: B
authors.lastname: Schneider
authors.forename: Silvana
authors.initials: S
authors.lastname: Breiteneder-Geleff
authors.forename: Heinrich M
authors.initials: HM
authors.lastname: Regele
authors.forename: Walter H
authors.initials: WH
authors.lastname: Hörl
authors.forename: Dontscho
authors.initials: D
authors.lastname: Kerjaschki
mesh_terms: D000328:Adult; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D000975:Antioxidants / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000188:drug therapy*; D006801:Humans; D007677:Kidney Function Tests; D015227:Lipid Peroxidation / Q000187:drug effects*; D008148:Lovastatin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011341:Probucol / Q000627:therapeutic use*; D011446:Prospective Studies; D011507:Proteinuria / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000924:Anticholesteremic Agents; D000975:Antioxidants; D008148:Lovastatin; D011341:Probucol