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Long-term beneficial effects of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker therapy for patients with advanced immunoglobulin A nephropathy and impaired renal function.
Clin Exp Nephrol. 2011 Oct; 15(5):700-707.CE

Abstract

BACKGROUND

There are few reports analyzing the effects of angiotensin-converting enzyme inhibitors (ACEIs) and/or angiotensin receptor blockers (ARBs) on the long-term renal survival of advanced immunoglobulin A nephropathy (IgAN) patients.

PATIENTS AND METHODS

In this retrospective cohort analysis, we divided 66 IgAN patients with an estimated glomerular filtration rate (eGFR) <60 ml/min into three groups: ACEI group (n = 20, treated with ACEIs), ARB group (n = 23, treated with ARBs), and control group (n = 23, treated with antiplatelet agents), and analyzed the clinical and histological background, renal survival rate until the primary endpoint of 50% decrease of eGFR from baseline, and the secondary endpoint of progression to end-stage renal disease, and the risk factors for progression.

RESULTS

The clinical and histological background without serum IgA and C3 were not significantly different among the three groups. The renal survival rate until the primary and secondary endpoints was significantly higher in the ACEI and ARB groups than in the control group. The independent risk factors for progression were higher mean blood pressure (hazard ratio [HR] 1.76, P = 0.04), higher histological grade (HR 2.54, P = 0.0184) at baseline, and without ACEIs or ARBs (HR 7.09, P = 0.001), but decreased proteinuria and blood pressure. The risk factors with resistance to ACEIs or ARBs were higher blood pressure and lower eGFR at baseline. There was no difference regarding the survival rate and the risk for progression between ACEI s and ARBs.

CONCLUSION

ACEIs or ARBs were effective for long-term renal survival of advanced IgAN, although proteinuria and blood pressure did not decrease.

Authors+Show Affiliations

Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. takamori@kc.twmu.ac.jp.Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21625892

Citation

Moriyama, Takahito, et al. "Long-term Beneficial Effects of Angiotensin-converting Enzyme Inhibitor and Angiotensin Receptor Blocker Therapy for Patients With Advanced Immunoglobulin a Nephropathy and Impaired Renal Function." Clinical and Experimental Nephrology, vol. 15, no. 5, 2011, pp. 700-707.
Moriyama T, Amamiya N, Ochi A, et al. Long-term beneficial effects of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker therapy for patients with advanced immunoglobulin A nephropathy and impaired renal function. Clin Exp Nephrol. 2011;15(5):700-707.
Moriyama, T., Amamiya, N., Ochi, A., Tsuruta, Y., Shimizu, A., Kojima, C., Itabashi, M., Takei, T., Uchida, K., & Nitta, K. (2011). Long-term beneficial effects of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker therapy for patients with advanced immunoglobulin A nephropathy and impaired renal function. Clinical and Experimental Nephrology, 15(5), 700-707. https://doi.org/10.1007/s10157-011-0455-8
Moriyama T, et al. Long-term Beneficial Effects of Angiotensin-converting Enzyme Inhibitor and Angiotensin Receptor Blocker Therapy for Patients With Advanced Immunoglobulin a Nephropathy and Impaired Renal Function. Clin Exp Nephrol. 2011;15(5):700-707. PubMed PMID: 21625892.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term beneficial effects of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker therapy for patients with advanced immunoglobulin A nephropathy and impaired renal function. AU - Moriyama,Takahito, AU - Amamiya,Nobuyuki, AU - Ochi,Ayami, AU - Tsuruta,Yuki, AU - Shimizu,Ari, AU - Kojima,Chiari, AU - Itabashi,Mitsuyo, AU - Takei,Takashi, AU - Uchida,Keiko, AU - Nitta,Kosaku, Y1 - 2011/05/31/ PY - 2010/06/11/received PY - 2011/04/25/accepted PY - 2011/6/1/entrez PY - 2011/6/1/pubmed PY - 2012/2/15/medline SP - 700 EP - 707 JF - Clinical and experimental nephrology JO - Clin Exp Nephrol VL - 15 IS - 5 N2 - BACKGROUND: There are few reports analyzing the effects of angiotensin-converting enzyme inhibitors (ACEIs) and/or angiotensin receptor blockers (ARBs) on the long-term renal survival of advanced immunoglobulin A nephropathy (IgAN) patients. PATIENTS AND METHODS: In this retrospective cohort analysis, we divided 66 IgAN patients with an estimated glomerular filtration rate (eGFR) <60 ml/min into three groups: ACEI group (n = 20, treated with ACEIs), ARB group (n = 23, treated with ARBs), and control group (n = 23, treated with antiplatelet agents), and analyzed the clinical and histological background, renal survival rate until the primary endpoint of 50% decrease of eGFR from baseline, and the secondary endpoint of progression to end-stage renal disease, and the risk factors for progression. RESULTS: The clinical and histological background without serum IgA and C3 were not significantly different among the three groups. The renal survival rate until the primary and secondary endpoints was significantly higher in the ACEI and ARB groups than in the control group. The independent risk factors for progression were higher mean blood pressure (hazard ratio [HR] 1.76, P = 0.04), higher histological grade (HR 2.54, P = 0.0184) at baseline, and without ACEIs or ARBs (HR 7.09, P = 0.001), but decreased proteinuria and blood pressure. The risk factors with resistance to ACEIs or ARBs were higher blood pressure and lower eGFR at baseline. There was no difference regarding the survival rate and the risk for progression between ACEI s and ARBs. CONCLUSION: ACEIs or ARBs were effective for long-term renal survival of advanced IgAN, although proteinuria and blood pressure did not decrease. SN - 1437-7799 UR - https://www.unboundmedicine.com/medline/citation/21625892/Long_term_beneficial_effects_of_angiotensin_converting_enzyme_inhibitor_and_angiotensin_receptor_blocker_therapy_for_patients_with_advanced_immunoglobulin_A_nephropathy_and_impaired_renal_function_ L2 - https://dx.doi.org/10.1007/s10157-011-0455-8 DB - PRIME DP - Unbound Medicine ER -