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

 Young-Il Jo  ;  Ha-Young Na  ;  Ju-Young Moon  ;  Sang-Woong Han  ;  Dong-Ho Yang  ;  Sang-Ho Lee  ;  Hyeong-Cheon Park  ;  Hoon-Young Choi  ;  So-Dug Lim  ;  Jeong-Hae Kie  ;  Yong-Kyu Lee  ;  Sug-Kyun Shin 
 KOREAN JOURNAL OF INTERNAL MEDICINE, Vol.31(2) : 335-343, 2016 
Journal Title
Issue Date
Adult ; Angiotensin II Type 1 Receptor Blockers/administration & dosage* ; Angiotensin II Type 1 Receptor Blockers/adverse effects ; Biomarkers/urine ; Blood Pressure ; Creatinine/urine ; Female ; Glomerulonephritis, IGA/diagnosis ; Glomerulonephritis, IGA/drug therapy* ; Glomerulonephritis, IGA/physiopathology ; Glomerulonephritis, IGA/urine ; Humans ; Male ; Middle Aged ; Prospective Studies ; Proteinuria/diagnosis ; Proteinuria/drug therapy* ; Proteinuria/physiopathology ; Proteinuria/urine ; Republic of Korea ; Time Factors ; Treatment Outcome ; Valsartan/administration & dosage* ; Valsartan/adverse effects
Angiotensin receptor antagonists ; Glomerulonephritis, IGA ; Proteinuria ; Safety ; Treatment outcome
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% ± 26.1% (p < 0.001) in the regular-dose group and -21.1% ± 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.
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Hyeong Cheon(박형천) ORCID logo https://orcid.org/0000-0002-1550-0812
Choi, Hoon Young(최훈영) ORCID logo https://orcid.org/0000-0002-4245-0339
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