Lisinopril versus lisinopril and losartan for mild childhood IgA nephropathy: a randomized controlled trial (JSKDC01 study) View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-10-03

AUTHORS

Yuko Shima, Koichi Nakanishi, Mayumi Sako, Mari Saito-Oba, Yuko Hamasaki, Hiroshi Hataya, Masataka Honda, Koichi Kamei, Kenji Ishikura, Shuichi Ito, Hiroshi Kaito, Ryojiro Tanaka, Kandai Nozu, Hidefumi Nakamura, Yasuo Ohashi, Kazumoto Iijima, Norishige Yoshikawa

ABSTRACT

BackgroundPersistent proteinuria seems to be a risk factor for progression of renal disease. Its reduction by angiotensin-converting inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) is renoprotective. Our previous pilot study showed that 2-year lisinopril therapy is effective and safe for children with mild IgA nephropathy. When combined with ACEI and ARB, reported results are of greater decrease in proteinuria than monotherapy in chronic glomerulonephritis, including IgA nephropathy. To date, however, there have been no randomized controlled trials in children.MethodsThis is an open-label, multicenter, prospective, and randomized phase II controlled trial of 63 children with biopsy-proven proteinuric mild IgA nephropathy. We compared efficacy and safety between patients undergoing lisinopril monotherapy and patients undergoing combination therapy of lisinopril and losartan to determine better treatment for childhood proteinuric mild IgA nephropathy.ResultsThere was no difference in proteinuria disappearance rate (primary endpoint) between the two groups (cumulative disappearance rate of proteinuria at 24 months: 89.3% vs 89% [combination vs monotherapy]). Moreover, there were no significant differences in side effects between the two groups.ConclusionsWe propose lisinopril monotherapy as treatment for childhood proteinuric mild IgA nephropathy as there are no advantages of combination therapy.Clinical trial registrationClinical trial registry, UMIN ID C000000006, https://www.umin.ac.jp. More... »

PAGES

837-846

References to SciGraph publications

Journal

TITLE

Pediatric Nephrology

ISSUE

5

VOLUME

34

Author Affiliations

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00467-018-4099-8

DOI

http://dx.doi.org/10.1007/s00467-018-4099-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1107372176

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30284023


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23 schema:description BackgroundPersistent proteinuria seems to be a risk factor for progression of renal disease. Its reduction by angiotensin-converting inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) is renoprotective. Our previous pilot study showed that 2-year lisinopril therapy is effective and safe for children with mild IgA nephropathy. When combined with ACEI and ARB, reported results are of greater decrease in proteinuria than monotherapy in chronic glomerulonephritis, including IgA nephropathy. To date, however, there have been no randomized controlled trials in children.MethodsThis is an open-label, multicenter, prospective, and randomized phase II controlled trial of 63 children with biopsy-proven proteinuric mild IgA nephropathy. We compared efficacy and safety between patients undergoing lisinopril monotherapy and patients undergoing combination therapy of lisinopril and losartan to determine better treatment for childhood proteinuric mild IgA nephropathy.ResultsThere was no difference in proteinuria disappearance rate (primary endpoint) between the two groups (cumulative disappearance rate of proteinuria at 24 months: 89.3% vs 89% [combination vs monotherapy]). Moreover, there were no significant differences in side effects between the two groups.ConclusionsWe propose lisinopril monotherapy as treatment for childhood proteinuric mild IgA nephropathy as there are no advantages of combination therapy.Clinical trial registrationClinical trial registry, UMIN ID C000000006, https://www.umin.ac.jp.
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32 IgA nephropathy
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35 Trials Registry
36 advantages
37 angiotensin
38 angiotensin II receptor blockers
39 best treatment
40 blockers
41 childhood IgA nephropathy
42 children
43 chronic glomerulonephritis
44 combination therapy
45 date
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52 factors
53 glomerulonephritis
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55 group
56 inhibitors
57 lisinopril
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60 losartan
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62 monotherapy
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72 rate
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78 risk factors
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