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
2011 Impact Factor: 2.337
2011 SCImago Journal Rankings: 0.226
DOIhttp://dx.doi.org/10.1191/0961203305lu2249oa
ISI Accession Number IDWOS:000234655400003
ReferencesReferences in Scopus
DC Field
Value
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
2011 Impact Factor: 2.337
2011 SCImago Journal Rankings: 0.226
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
Author Affiliations
  1. The University of Hong Kong
  2. Queen Mary Hospital Hong Kong