title: 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.affiliation: Department of Pediatrics, Kinki University School of Medicine, 377-2 Ohno-higashi, Osaka-sayama 589-8511, Japan.
authors.forename: Kazuro
authors.initials: K
authors.lastname: Yagi
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Okada
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Yanagida
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kuwajima
authors.forename: Masaru
authors.initials: M
authors.lastname: Ikeda
authors.forename: Keisuke
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Takemura
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004176:Dipyridamole / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005922:Glomerulonephritis, IGA / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007668:Kidney / Q000473:pathology; D008297:Male; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use*; D011507:Proteinuria / Q000188:drug therapy* / Q000209:etiology; D012263:Ribonucleosides / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D012263:Ribonucleosides; D014665:Vasodilator Agents; C010052:mizoribine; D004176:Dipyridamole; D011241:Prednisone