The Korean journal of internal medicine

  • 제31권2호
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  • Pages.335-343
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  • 2016
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  • 1226-3303(pISSN)
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  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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DOI QR Code

Effect of low-dose valsartan on proteinuria in normotensive immunoglobulin A nephropathy with minimal proteinuria: a randomized trial

  • Jo, Young-Il (Division of Nephrology, Department of Internal Medicine, Konkuk University Medical Center) ;
  • Na, Ha-Young (Division of Nephrology, Department of Internal Medicine, Konkuk University Medical Center) ;
  • Moon, Ju-Young (Division of Nephrology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Han, Sang-Woong (Division of Nephrology, Department of Internal Medicine, Hanyang University Guri Hospital) ;
  • Yang, Dong-Ho (Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University) ;
  • Lee, Sang-Ho (Division of Nephrology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Park, Hyeong-Cheon (Division of Nephrology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Choi, Hoon-Young (Division of Nephrology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Lim, So-Dug (Department of Pathology, Konkuk University Medical Center) ;
  • Kie, Jeong-Hae (Department of Pathology, National Health Insurance Corporation Ilsan Hospital) ;
  • Lee, Yong-Kyu (Division of Nephrology, Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital) ;
  • Shin, Sug-Kyun (Division of Nephrology, Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital)
  • 투고 : 2014.09.02
  • 심사 : 2014.10.20
  • 발행 : 2016.03.01
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: Immunoglobulin A nephropathy (IgAN) is a generally progressive disease, even in patients with favorable prognostic features. In this study, we aimed to investigate the antiproteinuric effect and tolerability of low-dose valsartan (an angiotensin II receptor blocker) therapy in normotensive IgAN patients with minimal proteinuria of less than 0.5 to 1.0 g/day. Methods: Normotensive IgAN patients, who had persistent proteinuria with a spot urine protein-to-creatinine ratio of 0.3 to 1.0 mg/mg creatinine, were recruited from five hospitals and randomly assigned to either 40 mg of valsartan as the low-dose group or 80 mg of valsartan as the regular-dose group. Clinical and laboratory data were collected at baseline, and at 4, 8, 12, and 24 weeks after valsartan therapy. Results: Forty-three patients (low-dose group, n = 23; regular-dose group, n = 20) were enrolled in the study. Proteinuria decreased significantly not only in the regular-dose group but also in the low-dose group. The change in urine protein-to-creatinine ratio at week 24 was $-41.3%{\pm}26.1%$ (p < 0.001) in the regular-dose group and $-21.1%{\pm}45.1%$ (p = 0.005) in the low-dose group. In the low-dose group, blood pressure was constant throughout the study period, and there was no symptomatic hypotension. In the regular-dose group, blood pressure decreased at weeks 8 and 12. No significant change in glomerular filtration rate, serum creatinine level, or serum potassium level was observed during the study period. Conclusions: Our results suggest that low-dose valsartan can significantly reduce proteinuria without causing any intolerability in normotensive IgAN patients with minimal proteinuria.

키워드

과제정보

연구 과제 주관 기관 : Konkuk University

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