title: Prednisolone co-administered with losartan confers renoprotection in patients with IgA nephropathy.
abstract: 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.
authors.affiliation: Division of Nephrology, Department of Medicine, National Hospital Organization, Nagasaki Medical Center, Nagasaki, Japan. y-horita@h8.dion.ne.jp
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Horita
authors.forename: Masato
authors.initials: M
authors.lastname: Tadokoro
authors.forename: Kouichi
authors.initials: K
authors.lastname: Taura
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Ashida
authors.forename: Mayumi
authors.initials: M
authors.lastname: Hiu
authors.forename: Takashi
authors.initials: T
authors.lastname: Taguchi
authors.forename: Akira
authors.initials: A
authors.lastname: Furusu
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: 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
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D005938:Glucocorticoids; D011239:Prednisolone; D019808:Losartan