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Article: Aliskiren combined with losartan in immunoglobulin A nephropathy: An open-labeled pilot study

TitleAliskiren combined with losartan in immunoglobulin A nephropathy: An open-labeled pilot study
Authors
Keywordsdirect renin inhibitor
IgA nephropathy
plasma renin activity
proteinuria
serum cytokines
Issue Date2012
PublisherOxford University Press. The Journal's web site is located at http://ndt.oxfordjournals.org/
Citation
Nephrology Dialysis Transplantation, 2012, v. 27 n. 2, p. 613-618 How to Cite?
AbstractBackground. Aliskiren is a relatively new oral direct renin inhibitor (DRI) that has been increasingly used for the treatment of diabetic nephropathy and hypertension. Its potential efficacy in nondiabetic chronic kidney diseases that are driven by renin-angiotensin system activation remains to be explored. Methods. From a teaching and regional hospital in Hong Kong between July 2009 and March 2010, patients with biopsy-proven immunoglobulin A nephropathy (IgAN) in whom the ratio of protein to creatinine, as measured in early morning urine samples, remained >113 mg/mmol (1000 mg/g), despite receiving the maximum recommended dose of losartan (100 mg daily) were recruited to receive additional DRI treatment. They were followed prospectively for 12 months with changes in proteinuria as the main outcome measure. Results. Twenty-five consecutive patients were enrolled. Treatment with aliskiren for 12 months reduced the mean urinary protein-to-creatinine ratio by 26.3% (95% confidence interval, 20.1-43.6; P = 0.001 versus baseline), with a reduction of ≥50% in 24% of patients. There were significant reductions in plasma renin activity (P < 0.0001) and serum interleukin-6 (P < 0.05) and transforming growth factor-β (P = 0.01) levels, compared with baseline. Two patients (8%) developed mild allergic reactions and six (24%) had transient hyperkalemia (K >5.5 mmol/L) during the study. Conclusion. Aliskiren confers an antiproteinuric effect in IgAN patients with significant residual proteinuria, despite receiving the recommended renoprotective treatment. Further prospective randomized trials are warranted to examine its long-term renoprotective potential. This trial is registered with the ClinicalTrials.gov number NCT00922311. © 2011 The Author.
Persistent Identifierhttp://hdl.handle.net/10722/137401
ISSN
2015 Impact Factor: 4.085
2015 SCImago Journal Rankings: 1.780
ISI Accession Number ID
Funding AgencyGrant Number
University of Hong Kong
Funding Information:

The study is supported by a Small Project Funding from the University of Hong Kong. This was not an industry supported study.

References

 

DC FieldValueLanguage
dc.contributor.authorTang, SCWen_HK
dc.contributor.authorLin, Men_HK
dc.contributor.authorTam, Sen_HK
dc.contributor.authorAu, WSen_HK
dc.contributor.authorMa, MKMen_HK
dc.contributor.authorYap, DYHen_HK
dc.contributor.authorHo, YWen_HK
dc.contributor.authorLai, KNen_HK
dc.date.accessioned2011-08-26T14:24:23Z-
dc.date.available2011-08-26T14:24:23Z-
dc.date.issued2012en_HK
dc.identifier.citationNephrology Dialysis Transplantation, 2012, v. 27 n. 2, p. 613-618en_HK
dc.identifier.issn0931-0509en_HK
dc.identifier.urihttp://hdl.handle.net/10722/137401-
dc.description.abstractBackground. Aliskiren is a relatively new oral direct renin inhibitor (DRI) that has been increasingly used for the treatment of diabetic nephropathy and hypertension. Its potential efficacy in nondiabetic chronic kidney diseases that are driven by renin-angiotensin system activation remains to be explored. Methods. From a teaching and regional hospital in Hong Kong between July 2009 and March 2010, patients with biopsy-proven immunoglobulin A nephropathy (IgAN) in whom the ratio of protein to creatinine, as measured in early morning urine samples, remained >113 mg/mmol (1000 mg/g), despite receiving the maximum recommended dose of losartan (100 mg daily) were recruited to receive additional DRI treatment. They were followed prospectively for 12 months with changes in proteinuria as the main outcome measure. Results. Twenty-five consecutive patients were enrolled. Treatment with aliskiren for 12 months reduced the mean urinary protein-to-creatinine ratio by 26.3% (95% confidence interval, 20.1-43.6; P = 0.001 versus baseline), with a reduction of ≥50% in 24% of patients. There were significant reductions in plasma renin activity (P < 0.0001) and serum interleukin-6 (P < 0.05) and transforming growth factor-β (P = 0.01) levels, compared with baseline. Two patients (8%) developed mild allergic reactions and six (24%) had transient hyperkalemia (K >5.5 mmol/L) during the study. Conclusion. Aliskiren confers an antiproteinuric effect in IgAN patients with significant residual proteinuria, despite receiving the recommended renoprotective treatment. Further prospective randomized trials are warranted to examine its long-term renoprotective potential. This trial is registered with the ClinicalTrials.gov number NCT00922311. © 2011 The Author.en_HK
dc.languageengen_US
dc.publisherOxford University Press. The Journal's web site is located at http://ndt.oxfordjournals.org/en_HK
dc.relation.ispartofNephrology Dialysis Transplantationen_HK
dc.subjectdirect renin inhibitoren_HK
dc.subjectIgA nephropathyen_HK
dc.subjectplasma renin activityen_HK
dc.subjectproteinuriaen_HK
dc.subjectserum cytokinesen_HK
dc.titleAliskiren combined with losartan in immunoglobulin A nephropathy: An open-labeled pilot studyen_HK
dc.typeArticleen_HK
dc.identifier.emailYap, DYH:desmondy@hku.hken_HK
dc.identifier.emailLai, KN:knlai@hku.hken_HK
dc.identifier.authorityYap, DYH=rp01607en_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1093/ndt/gfr349en_HK
dc.identifier.pmid21680850-
dc.identifier.scopuseid_2-s2.0-84856858651en_HK
dc.identifier.hkuros190675en_US
dc.identifier.hkuros209992-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84856858651&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume27en_HK
dc.identifier.issue2en_HK
dc.identifier.spage613en_HK
dc.identifier.epage618en_HK
dc.identifier.isiWOS:000300421300024-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridTang, SCW=36103837600en_HK
dc.identifier.scopusauthoridLin, M=48662246800en_HK
dc.identifier.scopusauthoridTam, S=7202037323en_HK
dc.identifier.scopusauthoridAu, WS=7202383097en_HK
dc.identifier.scopusauthoridMa, MKM=37034386700en_HK
dc.identifier.scopusauthoridYap, DYH=25958532000en_HK
dc.identifier.scopusauthoridHo, YW=7402555047en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK

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