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Article: Angiotensin inhibition or blockade for the treatment of patients with quiescent lupus nephritis and persistent proteinuria

TitleAngiotensin inhibition or blockade for the treatment of patients with quiescent lupus nephritis and persistent proteinuria
Authors
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
Citation
Lupus, 2005, v. 14 n. 12, p. 947-952 How to Cite?
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.
Persistent Identifierhttp://hdl.handle.net/10722/77255
ISSN
2023 Impact Factor: 1.9
2023 SCImago Journal Rankings: 0.812
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, KCen_HK
dc.contributor.authorLi, FKen_HK
dc.contributor.authorTang, Sen_HK
dc.contributor.authorTang, CSOen_HK
dc.contributor.authorLai, KNen_HK
dc.contributor.authorChan, TMen_HK
dc.date.accessioned2010-09-06T07:29:56Z-
dc.date.available2010-09-06T07:29:56Z-
dc.date.issued2005en_HK
dc.identifier.citationLupus, 2005, v. 14 n. 12, p. 947-952en_HK
dc.identifier.issn0961-2033en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77255-
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.en_HK
dc.languageengen_HK
dc.publisherSage Publications Ltd. The Journal's web site is located at http://lup.sagepub.comen_HK
dc.relation.ispartofLupusen_HK
dc.rightsLupus. Copyright © Sage Publications Ltd.en_HK
dc.subjectAngiotensin receptor blocker (ARB)en_HK
dc.subjectAngiotensin-converting enzyme inhibitor (ACEI)en_HK
dc.subjectLupus nephritisen_HK
dc.subjectProteinuriaen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAngiotensin Receptor Antagonistsen_HK
dc.subject.meshAngiotensin-Converting Enzyme Inhibitors - therapeutic useen_HK
dc.subject.meshBlood Pressure - drug effectsen_HK
dc.subject.meshCreatinine - blooden_HK
dc.subject.meshEnalapril - therapeutic useen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLosartan - therapeutic useen_HK
dc.subject.meshLupus Nephritis - drug therapyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshProteinuria - drug therapyen_HK
dc.subject.meshRamipril - therapeutic useen_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshSerum Albumin - analysisen_HK
dc.titleAngiotensin inhibition or blockade for the treatment of patients with quiescent lupus nephritis and persistent proteinuriaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0961-2033&volume=14&issue=12&spage=947&epage=952&date=2005&atitle=Angiotensin+inhibition+or+blockade+for+the+treatment+of+patients+with+quiescent+lupus+nephritis+and+persistent+proteinuriaen_HK
dc.identifier.emailTang, S: scwtang@hku.hken_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.emailChan, TM: dtmchan@hku.hken_HK
dc.identifier.authorityTang, S=rp00480en_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.identifier.authorityChan, TM=rp00394en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1191/0961203305lu2249oaen_HK
dc.identifier.pmid16425574-
dc.identifier.scopuseid_2-s2.0-30644460076en_HK
dc.identifier.hkuros117892en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-30644460076&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume14en_HK
dc.identifier.issue12en_HK
dc.identifier.spage947en_HK
dc.identifier.epage952en_HK
dc.identifier.isiWOS:000234655400003-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridTse, KC=7102609864en_HK
dc.identifier.scopusauthoridLi, FK=55210612400en_HK
dc.identifier.scopusauthoridTang, S=7403437082en_HK
dc.identifier.scopusauthoridTang, CSO=8681865300en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK
dc.identifier.scopusauthoridChan, TM=7402687700en_HK
dc.identifier.citeulike438580-
dc.identifier.issnl0961-2033-

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