title: Urinary TGF-beta1 as an indicator of antiproteinuric response to angiotensin II receptor blocker in proteinuric renal diseases.
abstract: BACKGROUND
  Angiotensin II receptor blockers (ARBs) reduce proteinuria, however, with large inter-individual variability. The present study investigated whether urinary transforming growth factor-beta1 (TGF-beta1) might predict the antiproteinuric efficacy of ARB in non-diabetic chronic renal disease.
  
  
  METHODS
  Non-diabetic patients with proteinuria (>1 g/day) received 50 mg of losartan daily followed by 100 mg in two treatment periods, each lasting 12 weeks. Clinical parameters and urinary TGF-beta1 levels were measured at baseline and during the treatment period.
  
  
  RESULTS
  In the whole group of patients, losartan treatment effectively decreased proteinuria. However, considerable differences existed among individual antiproteinuric responses. Good (n=34) or low (n=15) responders showed average proteinuria reduction of 69% or 17% from baseline, respectively. Both groups showed similar baseline biochemical and renal parameters and comparable degree of mean arterial blood pressure (MAP) reduction. However, the low responders were older and showed significantly higher baseline urinary TGF-beta1 levels. On multiple regression analysis, age, baseline urinary TGF-beta1 and % reduction in urinary TGF-beta1 and % reduction in MAP significantly predicted antiproteinuric response to losartan therapy.
  
  
  CONCLUSIONS
  The present data suggest that the determination of baseline urinary TGF-beta1 could be an useful indicator of short-term antiproteinuric response to ARB treatment in non-diabetic nephropathy.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. amp97@yumc.yonsei.ac.kr
authors.forename: Hyeong Cheon
authors.initials: HC
authors.lastname: Park
authors.forename: Hoon Young
authors.initials: HY
authors.lastname: Choi
authors.forename: Beom Seok
authors.initials: BS
authors.lastname: Kim
authors.forename: Hye Rim
authors.initials: HR
authors.lastname: An
authors.forename: Jae Sung
authors.initials: JS
authors.lastname: Lee
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Ha
authors.forename: Dae Suk
authors.initials: DS
authors.lastname: Han
mesh_terms: D000328:Adult; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D006801:Humans; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000188:drug therapy* / Q000652:urine; D053773:Transforming Growth Factor beta1 / Q000652:urine*
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D053773:Transforming Growth Factor beta1; D019808:Losartan