title: Renin-angiotensin system inhibitors reduce the progression of mesangioproliferative glomerulonephritis: 10 year follow-up.
abstract: BACKGROUND
  Proteinuria is a common presentation of mesangioproliferative glomerulonephritis (MsPGN). No studies are available on the long-term effect of treatment by renin-angiotensin system (RAS) inhibitors on renal outcome in MsPGN patients. This study prospectively evaluates the effects of RAS inhibitors on renal outcome in patients with low risk MsPGN followed up for 10 years using historical patients with similar features at the time of presentation as untreated controls.
  
  
  METHODS
  
  
  
  METHODS
  decrease of basal proteinuria>20% and loss>20% of basal glomerular filtrate rate (GFR) at the end of first year of observation. The patients were re-evaluated bimonthly during the first year and every 6 months thereafter.
  
  
  RESULTS
  Twenty-five patients fulfilled the selection criteria. After one year follow-up 19 patients reached the endpoint of proteinuria and no patient reached the endpoint of GFR. No significant change in blood pressure levels (BP) and GFR was registered, by contrast daily proteinuria decreased significantly (p<0.001), falling by 29% at sixth month and 47% at the end of the follow-up. The historical control group consisted of 15 untreated patients seen between 1987 and 1992. The two-way analysis of variance for repeated measures showed greater values of GFR (p<0.001) and lower levels of daily proteinuria (p<0.001) in treated patients as compared to untreated controls.
  
  
  CONCLUSIONS
  This 10-year follow-up study indicates that the early treatment with RAS inhibitors at low doses favourably influences the long-term renal outcome in proteinuric patients with MsPGN. Limitations were the small sample size and lack of randomization.
authors.affiliation: Department of Clinical and Experimental Medicine, Magna Graceia University of Catanzaro, Italy. piera.presta@gmail.com
authors.forename: Pierangela
authors.initials: P
authors.lastname: Presta
authors.forename: Roberto
authors.initials: R
authors.lastname: Minutolo
authors.forename: Carmela
authors.initials: C
authors.lastname: Iodice
authors.forename: Nicola
authors.initials: N
authors.lastname: Comi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Casoria
authors.forename: Laura
authors.initials: L
authors.lastname: Fuiano
authors.forename: Chiara
authors.initials: C
authors.lastname: Caglioti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Conte
authors.forename: Giorgio
authors.initials: G
authors.lastname: Fuiano
mesh_terms: D000328:Adult; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000009:adverse effects; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D001706:Biopsy; D018450:Disease Progression; D019317:Evidence-Based Medicine; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D015432:Glomerulonephritis, Membranoproliferative / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D019808:Losartan / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D011507:Proteinuria / Q000188:drug therapy / Q000473:pathology; D017257:Ramipril / Q000008:administration & dosage* / Q000009:adverse effects; D012084:Renin-Angiotensin System / Q000187:drug effects*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D019808:Losartan; D017257:Ramipril