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Article: Angiotensin inhibition or blockade for the treatment of patients with quiescent lupus nephritis and persistent proteinuria
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TitleAngiotensin inhibition or blockade for the treatment of patients with quiescent lupus nephritis and persistent proteinuria
 
AuthorsTse, KC1
Li, FK1
Tang, S1
Tang, CSO1
Lai, KN1
Chan, TM1 2
 
KeywordsAngiotensin receptor blocker (ARB)
Angiotensin-converting enzyme inhibitor (ACEI)
Lupus nephritis
Proteinuria
 
Issue Date2005
 
PublisherSage Publications Ltd. The Journal's web site is located at http://lup.sagepub.com
 
CitationLupus, 2005, v. 14 n. 12, p. 947-952 [How to Cite?]
DOI: http://dx.doi.org/10.1191/0961203305lu2249oa
 
AbstractAngiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) reduces proteinuria and the rate of renal function deterioration in diabetic nephropathy and other glomerular diseases, but its role in quiescent lupus nephritis has not been established. We conducted a retrospective study to investigate the effects of ACEI/ARB on proteinuria and renal function in patients with persistent proteinuria (> 1 g/day) despite resolution of acute lupus nephritis following immunosuppressive treatment. Fourteen out of 92 patients were included. The duration of treatment with ACEI/ARB was 52.1 ± 35.7 months. The levels of proteinuria, serum albumin, serum creatinine, systolic and diastolic blood pressure were 1.10 to 6.90 g/day, 35.8 ± 3.6 g/L, 102.54 ± 34.48 μmol/L, 137.6 ± 10.9 and 81.9 ± 9.2mmHg at baseline. Proteinuria and serum albumin showed significant sustained improvements after 6 and 24 months of treatment. Comparison of slopes for serial proteinuria, albumin and reciprocal of serum creatinine before and after treatment showed significant improvements in six (43%), eight (57%) and two patients, respectively. At last follow-up proteinuria remained significantly lower (0.36 g/day, P = 0.043) and albumin higher (41.3 ± 2.2 g/L, P = 0.023). Eleven (78.6%) patients had proteinuria improved by >50%, and five had insignificant proteinuria at last follow-up. Systolic blood pressure was significantly reduced from 6 months onwards, but this did not correlate with proteinuria reduction. Diastolic blood pressure, serum creatinine, creatinine clearance, anti-dsDNA, C3 and haemoglobin were not altered. We conclude that ACEI/ARB effectively reduces proteinuria and improves serum albumin in patients with persistent proteinuria despite quiescent lupus nephritis. © 2005 Edward Arnold (Publishers) Ltd.
 
ISSN0961-2033
2012 Impact Factor: 2.783
2012 SCImago Journal Rankings: 0.985
 
DOIhttp://dx.doi.org/10.1191/0961203305lu2249oa
 
ISI Accession Number IDWOS:000234655400003
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorTse, KC
 
dc.contributor.authorLi, FK
 
dc.contributor.authorTang, S
 
dc.contributor.authorTang, CSO
 
dc.contributor.authorLai, KN
 
dc.contributor.authorChan, TM
 
dc.date.accessioned2010-09-06T07:29:56Z
 
dc.date.available2010-09-06T07:29:56Z
 
dc.date.issued2005
 
dc.description.abstractAngiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) reduces proteinuria and the rate of renal function deterioration in diabetic nephropathy and other glomerular diseases, but its role in quiescent lupus nephritis has not been established. We conducted a retrospective study to investigate the effects of ACEI/ARB on proteinuria and renal function in patients with persistent proteinuria (> 1 g/day) despite resolution of acute lupus nephritis following immunosuppressive treatment. Fourteen out of 92 patients were included. The duration of treatment with ACEI/ARB was 52.1 ± 35.7 months. The levels of proteinuria, serum albumin, serum creatinine, systolic and diastolic blood pressure were 1.10 to 6.90 g/day, 35.8 ± 3.6 g/L, 102.54 ± 34.48 μmol/L, 137.6 ± 10.9 and 81.9 ± 9.2mmHg at baseline. Proteinuria and serum albumin showed significant sustained improvements after 6 and 24 months of treatment. Comparison of slopes for serial proteinuria, albumin and reciprocal of serum creatinine before and after treatment showed significant improvements in six (43%), eight (57%) and two patients, respectively. At last follow-up proteinuria remained significantly lower (0.36 g/day, P = 0.043) and albumin higher (41.3 ± 2.2 g/L, P = 0.023). Eleven (78.6%) patients had proteinuria improved by >50%, and five had insignificant proteinuria at last follow-up. Systolic blood pressure was significantly reduced from 6 months onwards, but this did not correlate with proteinuria reduction. Diastolic blood pressure, serum creatinine, creatinine clearance, anti-dsDNA, C3 and haemoglobin were not altered. We conclude that ACEI/ARB effectively reduces proteinuria and improves serum albumin in patients with persistent proteinuria despite quiescent lupus nephritis. © 2005 Edward Arnold (Publishers) Ltd.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationLupus, 2005, v. 14 n. 12, p. 947-952 [How to Cite?]
DOI: http://dx.doi.org/10.1191/0961203305lu2249oa
 
dc.identifier.citeulike438580
 
dc.identifier.doihttp://dx.doi.org/10.1191/0961203305lu2249oa
 
dc.identifier.epage952
 
dc.identifier.hkuros117892
 
dc.identifier.isiWOS:000234655400003
 
dc.identifier.issn0961-2033
2012 Impact Factor: 2.783
2012 SCImago Journal Rankings: 0.985
 
dc.identifier.issue12
 
dc.identifier.openurl
 
dc.identifier.pmid16425574
 
dc.identifier.scopuseid_2-s2.0-30644460076
 
dc.identifier.spage947
 
dc.identifier.urihttp://hdl.handle.net/10722/77255
 
dc.identifier.volume14
 
dc.languageeng
 
dc.publisherSage Publications Ltd. The Journal's web site is located at http://lup.sagepub.com
 
dc.publisher.placeUnited Kingdom
 
dc.relation.ispartofLupus
 
dc.relation.referencesReferences in Scopus
 
dc.rightsLupus. Copyright © Sage Publications Ltd.
 
dc.subject.meshAdult
 
dc.subject.meshAngiotensin Receptor Antagonists
 
dc.subject.meshAngiotensin-Converting Enzyme Inhibitors - therapeutic use
 
dc.subject.meshBlood Pressure - drug effects
 
dc.subject.meshCreatinine - blood
 
dc.subject.meshEnalapril - therapeutic use
 
dc.subject.meshFemale
 
dc.subject.meshFollow-Up Studies
 
dc.subject.meshHumans
 
dc.subject.meshLosartan - therapeutic use
 
dc.subject.meshLupus Nephritis - drug therapy
 
dc.subject.meshMale
 
dc.subject.meshProteinuria - drug therapy
 
dc.subject.meshRamipril - therapeutic use
 
dc.subject.meshRetrospective Studies
 
dc.subject.meshSerum Albumin - analysis
 
dc.subjectAngiotensin receptor blocker (ARB)
 
dc.subjectAngiotensin-converting enzyme inhibitor (ACEI)
 
dc.subjectLupus nephritis
 
dc.subjectProteinuria
 
dc.titleAngiotensin inhibition or blockade for the treatment of patients with quiescent lupus nephritis and persistent proteinuria
 
dc.typeArticle
 
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<description.abstract>Angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) reduces proteinuria and the rate of renal function deterioration in diabetic nephropathy and other glomerular diseases, but its role in quiescent lupus nephritis has not been established. We conducted a retrospective study to investigate the effects of ACEI/ARB on proteinuria and renal function in patients with persistent proteinuria (&gt; 1 g/day) despite resolution of acute lupus nephritis following immunosuppressive treatment. Fourteen out of 92 patients were included. The duration of treatment with ACEI/ARB was 52.1 &#177; 35.7 months. The levels of proteinuria, serum albumin, serum creatinine, systolic and diastolic blood pressure were 1.10 to 6.90 g/day, 35.8 &#177; 3.6 g/L, 102.54 &#177; 34.48 &#956;mol/L, 137.6 &#177; 10.9 and 81.9 &#177; 9.2mmHg at baseline. Proteinuria and serum albumin showed significant sustained improvements after 6 and 24 months of treatment. Comparison of slopes for serial proteinuria, albumin and reciprocal of serum creatinine before and after treatment showed significant improvements in six (43%), eight (57%) and two patients, respectively. At last follow-up proteinuria remained significantly lower (0.36 g/day, P = 0.043) and albumin higher (41.3 &#177; 2.2 g/L, P = 0.023). Eleven (78.6%) patients had proteinuria improved by &gt;50%, and five had insignificant proteinuria at last follow-up. Systolic blood pressure was significantly reduced from 6 months onwards, but this did not correlate with proteinuria reduction. Diastolic blood pressure, serum creatinine, creatinine clearance, anti-dsDNA, C3 and haemoglobin were not altered. We conclude that ACEI/ARB effectively reduces proteinuria and improves serum albumin in patients with persistent proteinuria despite quiescent lupus nephritis. &#169; 2005 Edward Arnold (Publishers) Ltd.</description.abstract>
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<subject.mesh>Male</subject.mesh>
<subject.mesh>Proteinuria - drug therapy</subject.mesh>
<subject.mesh>Ramipril - therapeutic use</subject.mesh>
<subject.mesh>Retrospective Studies</subject.mesh>
<subject.mesh>Serum Albumin - analysis</subject.mesh>
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Author Affiliations
  1. The University of Hong Kong
  2. Queen Mary Hospital Hong Kong