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Title: Beneficial effects of high-dose losartan in IgA nephritis
Authors: Woo, K.-T.
Chan, C.-M.
Tan, H.-K.
Choong, H.-L.
Foo, M.
Vathsala, A.
Lee, E.J.C. 
Tan, C.-C.
Lee, G.S.L.
Tan, S.H.
Lim, C.-H.
Chiang, G.S.C.
Fook-Chong, S.
Wong, S.K.S.
Keywords: ACEI
Glomerular filtration rate
Renal failure
Issue Date: Jun-2009
Citation: Woo, K.-T., Chan, C.-M., Tan, H.-K., Choong, H.-L., Foo, M., Vathsala, A., Lee, E.J.C., Tan, C.-C., Lee, G.S.L., Tan, S.H., Lim, C.-H., Chiang, G.S.C., Fook-Chong, S., Wong, S.K.S. (2009-06). Beneficial effects of high-dose losartan in IgA nephritis. Clinical Nephrology 71 (6) : 617-624. ScholarBank@NUS Repository.
Abstract: Aim: Several short-term studies have reported the efficacy of high-dose ARB in reducing proteinuria in patients with diabetic nephropathy. The benefits of long-term high-dose ARB losartan in IgA nephritis have not been explored. Method: This was a 6-year randomized trial in 207 patients with IgA nephritis comparing high-dose ARB (losartan 200 mg/day) with normal dose ARB (losartan 100 mg/day), normal dose ACEI (20 mg/day) and low-dose ACEI (10 mg/day). Multivariate ANOVA was used to test the effect of drug treatment on both eGFR and total urinary protein (TUP). Results: Comparing patients on high-dose ARB (n = 63) with those on normal dose ARB (n = 43), normal dose ACEI (n = 61) and low-dose ACEI (n = 40), patients on high Dose ARB had significantly higher eGFR (p < 0.0005) and lower proteinuria (p < 0.005) at the end of the study. The loss in eGFR was 0.7 ml/min/year for high-dose ARB compared to 3.2 - 3.5 ml/min/year for the other 3 groups (p = 0.0005). There were more patients on high-dose ARB with improvement in eGFR compared to other 3 groups (p < 0.001). Conclusion: Data from this study suggest that high-dose ARB therapy is more efficacious in reducing proteinuria and preserving renal function when compared with normal dose ARB and ACEI. In Year 5, patients on high-dose ARB had a gain in eGFR suggesting that there is possibility of recovery of renal function in these patients on long-term high-dose therapy. © 2009 Dustri-Verlag Dr. K. Feistle.
Source Title: Clinical Nephrology
ISSN: 03010430
Appears in Collections:Staff Publications

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