title: Effects of combination therapy with renin-angiotensin system inhibitors and eicosapentaenoic acid on IgA nephropathy.
abstract: OBJECTIVE
  The beneficial effects of renin-angiotensin-aldosterone system inhibitors (RASI) and the omega-3 polyunsaturated fatty acid eicosapentaenoic acid (EPA) on IgA nephropathy (IgAN) have been reported. However, it is unknown whether these agents have any synergistic interactions.
  
  
  METHODS
  We divided 38 IgAN patients into two groups: an EPA group (n=18) treated with RASI plus EPA and a DILAZEP group (n=20) treated with RASI plus dilazep dihydrochloride. We analyzed the clinical and histological background of each patient, any relevant clinical findings obtained one year after treatment and any factors significantly related to decreases in proteinuria.
  
  
  RESULTS
  The clinical findings were largely similar between the groups, except for body mass index (24.9±4.5 in the EPA group vs. 21.4±2.1 in the DILAZEP group, p=0.0041) and total cholesterol (median: 206.0 vs. 177.5 mg/dL, p=0.0493). The histological findings, evaluated according to the Oxford classification, were also similar between the groups. At one year after treatment, the EPA group demonstrated a significantly decreased mean blood pressure (from 94.7±9.0 to 86.4±7.2 mmHg, p=0.0007) and a significantly decreased median level of proteinuria (from 0.80 to 0.41 g/g creatinine, p<0.001). In the DILAZEP group, the mean blood pressure significantly decreased (from 95.2±13.2 to 88.1±7.7 mmHg, p<0.001) without any significant decrease in the median level of proteinuria (from 0.88 to 0.60 g/g creatinine). According to a multivariate logistic analysis, EPA was found to be the only independent factor related to decreases in proteinuria (odds ratio = 5.073, 95% CI: 1.18-26.7, p=0.0285).
  
  
  CONCLUSIONS
  We conclude that EPA accelerates the effects of RASI and thus decreases the proteinuria observed in patients with IgAN.
authors: Department of Medicine, Kidney Center, Tokyo Women's Medical University, Japan. takamori@kc.twmu.ac.jp
authors: Takahito
authors: T
authors: Moriyama
authors: Chihiro
authors: C
authors: Iwasaki
authors: Kayu
authors: K
authors: Tanaka
authors: Ayami
authors: A
authors: Ochi
authors: Ari
authors: A
authors: Shimizu
authors: Syunji
authors: S
authors: Shiohira
authors: Mitsuyo
authors: M
authors: Itabashi
authors: Takashi
authors: T
authors: Takei
authors: Keiko
authors: K
authors: Uchida
authors: Ken
authors: K
authors: Tsuchiya
authors: Kosaku
authors: K
authors: Nitta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D015331:Cohort Studies; D004109:Dilazep / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage*; D005260:Female; D005922:Glomerulonephritis, IGA / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012084:Renin-Angiotensin System / Q000187:drug effects* / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015118:Eicosapentaenoic Acid; D004109:Dilazep