title: Angiotensin-converting-enzyme inhibitors slow renal decline in IgA nephropathy, independent of tubulointerstitial fibrosis at presentation.
abstract: BACKGROUND
  Tubulointerstitial fibrosis (TIF) is a marker of progression of diabetic and non-diabetic nephropathy, correlating with creatinine clearance (CCr), and functional outcome. Angiotensin-converting-enzyme inhibitors (ACEIs) slow the rate of decline of renal function in proteinuric patients.
  
  
  OBJECTIVE
  To examine whether ACEIs affect TIF, directly or indirectly.
  
  
  METHODS
  Prospective 3-year follow-up study.
  
  
  METHODS
  We enrolled 49 patients with IgA nephropathy (IgAN), treating some with ACE inhibitors (n = 26, 1-2 mg/day temocapril or trandolapril) and some with calcium-channel blockers (CCB, n = 23, 2.5-5 mg/day amlodipine). Blood pressure, serum creatinine, and urinalysis were measured monthly, and 24-h endogenous creatinine clearance (CCr) at least once a year.
  
  
  RESULTS
  In the CCB group, TIF was positively correlated with the rate of decline in CCr (dCCr), consistent with previous observations. In the ACEI group, dCCr was lower (0.02 +/- 0.02 vs. 0.06 +/- 0.03), and the TIF-dCCr correlation was absent.
  
  
  CONCLUSIONS
  In the absence of post-treatment histological data, it is not possible to say whether ACEIs have an effect on TIF. However, ACEIs appear to slow the progression of renal failure in IgAN, regardless of the degree of TIF at presentation.
authors.affiliation: Department of Nephrology, Saitama Medical School, 38 Morohongo, Moroyama-cho, Irumagun, Saitama 350-0495, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kanno
authors.forename: H
authors.initials: H
authors.lastname: Okada
authors.forename: Y
authors.initials: Y
authors.lastname: Yamaji
authors.forename: Y
authors.initials: Y
authors.lastname: Nakazato
authors.forename: H
authors.initials: H
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003404:Creatinine / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D005355:Fibrosis; D005922:Glomerulonephritis, IGA / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D007684:Kidney Tubules / Q000473:pathology*; D008297:Male; D009395:Nephritis, Interstitial / Q000150:complications / Q000188:drug therapy*; D011446:Prospective Studies; D011507:Proteinuria / Q000188:drug therapy; D013841:Thiazepines / Q000627:therapeutic use
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D007211:Indoles; D013841:Thiazepines; C052035:trandolapril; C055603:temocapril hydrochloride; D003404:Creatinine