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Article: A randomized prospective comparison of nadolol, captopril with or without ticlopidine on disease progression in IgA nephropathy

TitleA randomized prospective comparison of nadolol, captopril with or without ticlopidine on disease progression in IgA nephropathy
Authors
KeywordsAngiotension converting enzyme inhibitors
IgA nephropathy
Nadolol
Progression
Renal failure
Ticlopidine
Issue Date1998
PublisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/NEP
Citation
Nephrology, 1998, v. 4 n. 1-2, p. 19-26 How to Cite?
AbstractTo determine if angiotensin converting enzyme inhibitors (ACEI) and antiplatelet agents have any added advantages over beta-blockers in preventing disease progression in IgA nephropathy (IgAN), 52 patients with IgAN with at least two features suggestive of progressive disease, namely, proteinuria >1 gm/day, mean blood pressure (MBP)>107 mmHg, serum creatinine 0.12-0.4 mmol/L and the presence of glomerulosclerosis and/or tubulointerstitial fibrosis on initial biopsy were randomized to receive nadolol (N), captopril (C) and captopril plus ticoplidine (CT). In hypertensive subjects, the dose N and C was adjusted to normalize MBP. In normotensive subjects the dose was adjusted to achieve a reduction of MBP of 5-10 mmHg. Five patients withdrew prematurely before reaching the end of the study period. The results after a minimal period of 3 years follow-up were available in the remaining 47 patients (n = 16, 12 and 19 in groups N, C and CT, respectively). Target of blood pressure (BP) treatment was achieved in all patients and the post-treatment MBP was comparable among the three groups. In C and CT, peripheral blood renin increased significantly while in CT, in vitro platelet aggregation decreased significantly following treatment. Urinary protein and albumin excretion decreased significantly in all treatment groups but there was no difference among the three groups. Progression of renal failure as measured by life table analysis of the percentage of patients with doubling of serum creatinine and by the slope of the reciprocal of serum creatinine (mean ± SEM: -0.021 ± 0.014; -0.016 ± 0.010 and -0.017 ± 0.008 for N, C and CT, respectively) and of glomerular filtration rate as measured by plasma disappearance of injected Cr 51EDTA over time (mean ± SEM: -0.556 ± 0.157, -0.739 ± 0.304 and -0.543 ± 0.274 for N, C and CT) were similar among the three groups. In this small comparative study, ACEI does not appear to be better than long-acting beta- blocker in retarding disease progression in patients with IgAN and ticlopidine confers no additional benefit.
Persistent Identifierhttp://hdl.handle.net/10722/88675
ISSN
2015 Impact Factor: 1.796
2015 SCImago Journal Rankings: 0.894
References

 

DC FieldValueLanguage
dc.contributor.authorCheng, IKPen_HK
dc.contributor.authorFang, GXen_HK
dc.contributor.authorWong, MCen_HK
dc.contributor.authorJi, YLen_HK
dc.contributor.authorChan, KWen_HK
dc.contributor.authorYeung, HWDen_HK
dc.date.accessioned2010-09-06T09:46:30Z-
dc.date.available2010-09-06T09:46:30Z-
dc.date.issued1998en_HK
dc.identifier.citationNephrology, 1998, v. 4 n. 1-2, p. 19-26en_HK
dc.identifier.issn1320-5358en_HK
dc.identifier.urihttp://hdl.handle.net/10722/88675-
dc.description.abstractTo determine if angiotensin converting enzyme inhibitors (ACEI) and antiplatelet agents have any added advantages over beta-blockers in preventing disease progression in IgA nephropathy (IgAN), 52 patients with IgAN with at least two features suggestive of progressive disease, namely, proteinuria >1 gm/day, mean blood pressure (MBP)>107 mmHg, serum creatinine 0.12-0.4 mmol/L and the presence of glomerulosclerosis and/or tubulointerstitial fibrosis on initial biopsy were randomized to receive nadolol (N), captopril (C) and captopril plus ticoplidine (CT). In hypertensive subjects, the dose N and C was adjusted to normalize MBP. In normotensive subjects the dose was adjusted to achieve a reduction of MBP of 5-10 mmHg. Five patients withdrew prematurely before reaching the end of the study period. The results after a minimal period of 3 years follow-up were available in the remaining 47 patients (n = 16, 12 and 19 in groups N, C and CT, respectively). Target of blood pressure (BP) treatment was achieved in all patients and the post-treatment MBP was comparable among the three groups. In C and CT, peripheral blood renin increased significantly while in CT, in vitro platelet aggregation decreased significantly following treatment. Urinary protein and albumin excretion decreased significantly in all treatment groups but there was no difference among the three groups. Progression of renal failure as measured by life table analysis of the percentage of patients with doubling of serum creatinine and by the slope of the reciprocal of serum creatinine (mean ± SEM: -0.021 ± 0.014; -0.016 ± 0.010 and -0.017 ± 0.008 for N, C and CT, respectively) and of glomerular filtration rate as measured by plasma disappearance of injected Cr 51EDTA over time (mean ± SEM: -0.556 ± 0.157, -0.739 ± 0.304 and -0.543 ± 0.274 for N, C and CT) were similar among the three groups. In this small comparative study, ACEI does not appear to be better than long-acting beta- blocker in retarding disease progression in patients with IgAN and ticlopidine confers no additional benefit.en_HK
dc.languageengen_HK
dc.publisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/NEPen_HK
dc.relation.ispartofNephrologyen_HK
dc.subjectAngiotension converting enzyme inhibitorsen_HK
dc.subjectIgA nephropathyen_HK
dc.subjectNadololen_HK
dc.subjectProgressionen_HK
dc.subjectRenal failureen_HK
dc.subjectTiclopidineen_HK
dc.titleA randomized prospective comparison of nadolol, captopril with or without ticlopidine on disease progression in IgA nephropathyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1320-5358&volume=4&spage=19&epage=26&date=1998&atitle=A+randomized+prospective+comparison+of+nadolol,+captopril+with+or+without+ticlopidine+on+disease+progression+in+IgA+nephropathyen_HK
dc.identifier.emailChan, KW:hrmtckw@hku.hken_HK
dc.identifier.authorityChan, KW=rp00330en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1046/j.1440-1797.1998.d01-12.x-
dc.identifier.scopuseid_2-s2.0-0031747934en_HK
dc.identifier.hkuros34126en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0031747934&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume4en_HK
dc.identifier.issue1-2en_HK
dc.identifier.spage19en_HK
dc.identifier.epage26en_HK
dc.publisher.placeAustraliaen_HK

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