Antiproteinuric effect of angiotensin-converting enzyme inhibitors and an angiotensin II receptor blocker in patients with lupus nephritis.
Although the effects of angiotensin II receptor blockers (ARBs) on non-diabetic glomerulonephritis have been reported, studies of their effects on collagen-vascular diseases, particularly lupus nephritis, are limited. In this retrospective, observational study, systemic lupus erythematosus (SLE) patients (n = 7) with lupus nephritis and uncontrolled proteinuria were treated with an angiotensin-converting enzyme inhibitor followed by the ARB losartan (25 - 50 mg/day). Urinary protein excretion and renal function were evaluated. After 12 months of losartan, mean urinary protein excretion decreased significantly by 84.8%. Mean systolic and diastolic blood pressures also decreased significantly during the 12 months of losartan treatment, although not in normotensive patients. Complement 4, total complement activity and anti-dsDNA antibody levels, which are indices of SLE activity, and serum creatinine levels, which is an index of renal function, showed no change in response to losartan treatment. A more extensive evaluation of the effects of ARBs in patients with lupus nephritis and poorly controlled proteinuria is required.
Kitamura
N
N
Division of Haematology and Rheumatology, Department of Medicine, School of Medicine, Nihon University, Tokyo, Japan. noboruk@med.nihon-u.ac.jp
Matsukawa
Y
Y
Takei
M
M
Sawada
S
S
D000293:Adolescent; D000328:Adult; D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D000818:Animals; D000974:Antibodies, Antinuclear / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D003165:Complement System Proteins / Q000276:immunology; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D019808:Losartan / Q000494:pharmacology / Q000627:therapeutic use; D008181:Lupus Nephritis / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D008875:Middle Aged; D011507:Proteinuria / Q000188:drug therapy*
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000974:Antibodies, Antinuclear; D003165:Complement System Proteins; D003404:Creatinine; D019808:Losartan