American Journal of Kidney Diseases
Volume 53, Issue 1 , Pages 26-32 , January 2009

Combination Therapy of Prednisone and ACE Inhibitor Versus ACE-Inhibitor Therapy Alone in Patients With IgA Nephropathy: A Randomized Controlled Trial

  • Jicheng Lv, MD

      Affiliations

    • Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Beijing, People's Republic of China
    • Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, People's Republic of China
    • ,
  • Hong Zhang, MD, PhD

      Affiliations

    • Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Beijing, People's Republic of China
    • Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, People's Republic of China
    • Corresponding Author InformationAddress correspondence to Hong Zhang, MD, PhD, Renal Division, Peking University First Hospital, Institute of Nephrology, Peking University, No 8, Xishiku St, Xicheng District, Beijing, 100034 China
    • ,
  • Yuqing Chen, MD

      Affiliations

    • Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Beijing, People's Republic of China
    • Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, People's Republic of China
    • ,
  • Guangtao Li, MD

      Affiliations

    • Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Beijing, People's Republic of China
    • Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, People's Republic of China
    • ,
  • Lei Jiang, MD

      Affiliations

    • Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Beijing, People's Republic of China
    • Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, People's Republic of China
    • ,
  • Ajay K. Singh, MB, FRCP

      Affiliations

    • Renal Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
    • ,
  • Haiyan Wang, MD

      Affiliations

    • Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Beijing, People's Republic of China
    • Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, People's Republic of China

Received 24 February 2008 ,Accepted 22 July 2008.

References 

  1. D'Amico G. Natural history of idiopathic IgA nephropathy: Role of clinical and histological prognostic factors. Am J Kidney Dis. 2000;36:227–237
  2. Lv JC, Zhang H, Zhou Y, Li GT, Zou WZ, Wang HY. Natural history and predictive factors of prognosis: A long-term follow up of 204 cases in China. Nephrology (Carlton). 2008;13:242–246
  3. Barratt J, Feehally J. IgA nephropathy. J Am Soc Nephrol. 2005;16:2088–2097
  4. Reich HN, Troyanov S, Scholey JW, Cattran DC Toronto Glomerulonephritis Registry. Remission of proteinuria improves prognosis in IgA nephropathy. J Am Soc Nephrol. 2007;18:3177–3183
  5. Jafar TH, Stark PC, Schmid CH, et al. Progression of chronic kidney disease: The role of blood pressure control, proteinuria, and angiotensin-converting enzyme inhibition: A patient-level meta-analysis. Ann Intern Med. 2003;139:244–252
  6. Strippoli GF, Manno C, Schena FP. An “evidence-based” survey of therapeutic options for IgA nephropathy: Assessment and criticism. Am J Kidney Dis. 2003;41:1130–1139
  7. Locatelli F, Vecchio LD, Pozzi C. IgA glomerulonephritis: Beyond angiotensin-converting enzyme inhibitors. Nat Clin Pract Nephrol. 2006;2:24–31
  8. Locatelli F, Pozzi C, Andrulli S. IgA nephritis: ACE inhibitors, steroids, both or neither?. Nephrol Dial Transplant. 2006;21:3357–3361
  9. Ballardie FW. Quantitative appraisal of treatment options for IgA nephropathy. J Am Soc Nephrol. 2007;18:2806–2809
  10. Pozzi C, Bolasco PG, Fogazzi GB, et al. Corticosteroids in IgA nephropathy: A randomized clinical trial. Lancet. 1999;353:883–887
  11. Pozzi C, Andrulli S, Del Vecchio L, et al. Corticosteroids effectiveness in IgA nephropathy: Long-term results of a randomized, controlled trial. J Am Soc Nephrol. 2004;15:157–163
  12. Hwang YC, Lee TW, Kim MJ, Yang MH, Ihm CG. Clinical course of patients with IgA nephropathy between combined treatment of immunosuppressive agents and ACE inhibitor and ACE inhibitor alone. Korean J Intern Med. 2001;16:105–109
  13. Manno C, Gesualdo L, D'Altri C, Rossini M, Grandaliano G, Schena FP. Prospective randomized controlled multicenter trial on steroids plus ramipril in proteinuric IgA nephropathy. J Nephrol. 2001;14:248–252
  14. Floege J, Eitner F. Immune modulating therapy for IgA nephropathy: Rationale and evidence. Semin Nephrol. 2008;28:38–47
  15. Ma YC, Zuo L, Chen JH, et al. Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease. J Am Soc Nephrol. 2006;17:3037–3044
  16. Donadio JV, Larson TS, Bergstalh EJ, Grande JP. A randomized trial of high-dose compared with low-dose omega-3 fatty acids in severe IgA nephropathy. J Am Soc Nephrol. 2001;12:791–799
  17. Praga M, Gutiérrez E, González E, Morales E, Hernández E. Treatment of IgA nephropathy with ACE inhibitors: A randomized and controlled trial. J Am Soc Nephrol. 2003;14:1578–1583
  18. Frisch G, Lin J, Rosenstock J, et al. Mycophenolate mofetil (MMF) vs placebo in patients with moderately advanced IgA nephropathy: A double-blind randomized controlled trial. Nephrol Dial Transplant. 2005;20:2139–2145
  19. The GISEN Group (Gruppo Italiano di Studi Epidemiologici in Nefrologia). Randomised placebo-controlled trial of effect of ramipril on decline in glomerular filtration rate and risk of terminal renal failure in proteinuric, non-diabetic nephropathy. Lancet. 1997;349:1857–1863
  20. Ruggenenti P, Perna A, Gherardi G, Gaspari F, Benini R, Remuzzi G. Renal function and requirement for dialysis in chronic nephropathy patients on long-term ramipril: REIN follow-up trial. Gruppo Italiano di Studi Epidemiologici in Nefrologia (GISEN). Ramipril Efficacy in Nephropathy. Lancet. 1998;352:1252–1256
  21. Maschio G, Alberti D, Janin G, et al. Effect of the angiotensin converting-enzyme inhibitor benazepril on the progression of chronic renal insufficiency. N Engl J Med. 1996;334:939–945
  22. Ruggenenti P, Perna A, Gherardi G, et al. Renoprotective properties of ACE-inhibition in non-diabetic nephropathies with non-nephrotic proteinuria. Lancet. 1999;354:359–364
  23. Hou FF, Zhang X, Zhang GH, et al. Efficacy and safety of benazepril for advanced chronic renal insufficiency. N Engl J Med. 2006;354:131–140
  24. Nakao N, Yoshimura A, Morita H, Takada M, Kayano T, Ideura T. Combination treatment of angiotensin-II receptor blocker and angiotensin-converting-enzyme inhibitor in non-diabetic renal disease (COOPERATE): A randomized controlled trial. Lancet. 2003;361:117–124
  25. Lai KN, Lai FM, Ho CP, Chan KW. Corticosteroid therapy in IgA nephropathy with nephrotic syndrome: A long-term controlled trial. Clin Nephrol. 1986;26:174–180
  26. Kobayashi Y, Hiki Y, Kokubo T, Horii A, Tateno S. Steroid therapy during the early stage of progressive IgA nephropathy: A 10-year follow up study. Nephron. 1996;72:237–242
  27. Samuels JA, Strippoli GF, Craig JC, Schena FP, Molony DA. Immunosuppressive treatments for immunoglobulin A nephropathy: A meta-analysis of randomized controlled trials. Nephrology (Carlton). 2004;9:177–185

 Originally published online as doi:10.1053/j.ajkd.2008.07.029 on October 20, 2008.Trial registration: www.clinicaltrials.gov; study number:NCT00378443.

PII: S0272-6386(08)01230-4

doi: 10.1053/j.ajkd.2008.07.029

American Journal of Kidney Diseases
Volume 53, Issue 1 , Pages 26-32 , January 2009

Article Tools

* Image Usage & Resolution