Effects of co-administration of urokinase and benazepril on severe IgA nephropathy.
BACKGROUND
The availability of treatment for IgA nephropathy (IgAN) is limited. Method. A prospective randomized controlled clinical trial was performed to evaluate the effects of therapy with urokinase (UK) and benazepril (BZ, an angiotensin-converting enzyme inhibitor) or BZ alone on severe IgAN. We divided 71 cases of IgAN, Lee's grade >/=III and with fibrinogen deposits, into two groups to be treated for 12 months with either UK + BZ or BZ alone.


RESULTS
There was no significant difference between the two groups in baseline clinical and histopathological data. After 12 months of treatment, 25 of 35 patients (71.4%) in the UK + BZ group and 16 of 36 (44.4%) in the BZ-alone group had a >/=50% decrease in 24-h urinary protein excretion compared with the baseline (chi(2) test, P<0.05). Proteinuria significantly decreased at 6 and 12 months of treatment in both groups compared with baseline (P<0.01 in the UK + BZ group, P<0.05 in the BZ group), and the therapeutic efficiency of UK + BZ was better than that of BZ alone (P<0.05 at 6 and 12 months). The endogenous creatinine clearance rate (Ccr) was stable in the UK + BZ group, while Ccr declined significantly at 6 and 12 months in the BZ-alone group compared with baseline (P<0.05, respectively). The Ccrs of the two groups at 12 months of treatment were statistically different (P<0.05).


CONCLUSIONS
Combined therapy with UK and BZ was more effective than with BZ alone in reducing proteinuria and protecting renal function in patients with severe IgAN.
Chen
Xiangmei
X
Kidney Center of PLA, Department of Nephrology, Chinese General Hospital of PLA, Fuxing Road 28, Beijing 100853, China. xmchen@public.bta.net.cn
Qiu
Qiang
Q
Tang
Li
L
Liu
Shuwen
S
Cai
Guangyan
G
Liu
Hongtao
H
Xie
Yuansheng
Y
D000293:Adolescent; D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D001552:Benzazepines / Q000008:administration & dosage*; D002648:Child; D005260:Female; D005922:Glomerulonephritis, IGA / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*
D000806:Angiotensin-Converting Enzyme Inhibitors; D001552:Benzazepines; D014568:Urokinase-Type Plasminogen Activator; C044946:benazepril