Prednisolone co-administered with losartan confers renoprotection in patients with IgA nephropathy.
BACKGROUND
Treatment options for progressive IgA nephropathy are limited.


METHODS
We performed a small, randomized controlled trial to evaluate the effects of prednisolone (PSL, 30 mg/dL, gradually tapered to 5 mg/dL over two years) plus 50 mg/day of losartan (LST, an angiotensin II receptor blocker) or PSL alone on IgA nephropathy. We separated 38 patients (age, 33 +/- 11 years; creatinine clearance, 103 +/- 31 mL/min; proteinuria, 1.6 +/- 0.5 g/day) into two groups that were treated with either PSL plus LST or PSL alone, and compared the proteinuria and creatinine clearance after two years. Baseline and histopathological data did not significantly differ between the two groups.


RESULTS
Two years of treatment in both groups significantly decreased proteinuria compared with baseline, and PSL plus LST (from 1.6 +/- 0.6 to 0.3 +/- 0.1 g/day, p < 0.05) was more effective than PSL alone (from 1.6 +/- 0.3 to 0.5 +/- 0.1 g/day, p < 0.05). Creatinine clearance in both groups was similar at the start of study but significantly differed at the end of the study (PSL plus LST, 104.3 +/- 36.4 to 100.4 +/- 38.9 mL/min; PSL alone, 103.4 +/- 28.5 to 84.8 +/- 34.3 mL/min, p < 0.05).


CONCLUSIONS
Combined therapy with PSL plus LST appears to be more effective than PSL alone in reducing proteinuria and protecting renal function in patients with IgA nephropathy.
Horita
Yoshio
Y
Division of Nephrology, Department of Medicine, National Hospital Organization, Nagasaki Medical Center, Nagasaki, Japan. y-horita@h8.dion.ne.jp
Tadokoro
Masato
M
Taura
Kouichi
K
Ashida
Ryuichi
R
Hiu
Mayumi
M
Taguchi
Takashi
T
Furusu
Akira
A
Kohno
Shigeru
S
D000328:Adult; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005922:Glomerulonephritis, IGA / Q000188:drug therapy*; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D019808:Losartan / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage*; D011446:Prospective Studies
D047228:Angiotensin II Type 1 Receptor Blockers; D005938:Glucocorticoids; D011239:Prednisolone; D019808:Losartan