Abstract
Even in children with mild immunoglobulin (Ig)A nephropathy (IgA-N) showing minimal/focal mesangial proliferation, persistent proteinuria seems to be a risk factor for progression of the disease, indicating the need for an effective and safe treatment even in such cases. Studies carried out to date have indicated that angiotensin-converting enzyme inhibitors (ACEIs) reduce urinary protein excretion and preserve renal function in adult IgA-N. However, no prospective study of ACEI only for childhood IgA-N has yet been carried out. In this prospective single-arm pilot trial, we administered lisinopril (0.4 mg/kg per day) as therapeutic treatment to 40 children with mild IgA-N with proteinuria [morning urinary protein/creatinine ratio (uP/Cr) ≥ 0.2 g/g]. Thirty-three patients reached the primary endpoint (uP/Cr < 0.2) during the 2-year treatment period. The cumulative disappearance rate of proteinuria determined by the Kaplan-Meier method was 80.9%. Mean uP excretion was reduced from 0.40 to 0.18 g/m2/day (p < 0.0001). Of the 40 patients treated, five (12.5%) showed dizziness, and four of these five needed the lisinopril dose reduced. However, lisinopril therapy was continued in all patients during the 2-year treatment period. No other side effect, such as cough, was observed. We conclude that the efficacy and safety of lisinopril is seemingly acceptable for the treatment of children with mild IgA-N.
| Original language | English |
|---|---|
| Pages (from-to) | 845-849 |
| Number of pages | 5 |
| Journal | Pediatric Nephrology |
| Volume | 24 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2009 |
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Keywords
- Angiotensin-converting enzyme inhibitor
- Focal mesangial proliferation
- Minimal change
- Proteinuria
- Renin-angiotensin system
- Urinary protein excretion
- Urinary protein to creatinine ratio
ASJC Scopus subject areas
- Nephrology
- Pediatrics, Perinatology, and Child Health
Cite this
Efficacy and safety of lisinopril for mild childhood IgA nephropathy : A pilot study. / Nakanishi, Koichi; Iijima, Kzumoto; Ishikura, Kenji; Hataya, Hiroshi; Awazu, Midori; Sako, Mayumi; Honda, Masataka; Yoshikawa, Norishige.
In: Pediatric Nephrology, Vol. 24, No. 4, 2009, p. 845-849.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Efficacy and safety of lisinopril for mild childhood IgA nephropathy
T2 - A pilot study
AU - Nakanishi, Koichi
AU - Iijima, Kzumoto
AU - Ishikura, Kenji
AU - Hataya, Hiroshi
AU - Awazu, Midori
AU - Sako, Mayumi
AU - Honda, Masataka
AU - Yoshikawa, Norishige
PY - 2009
Y1 - 2009
N2 - Even in children with mild immunoglobulin (Ig)A nephropathy (IgA-N) showing minimal/focal mesangial proliferation, persistent proteinuria seems to be a risk factor for progression of the disease, indicating the need for an effective and safe treatment even in such cases. Studies carried out to date have indicated that angiotensin-converting enzyme inhibitors (ACEIs) reduce urinary protein excretion and preserve renal function in adult IgA-N. However, no prospective study of ACEI only for childhood IgA-N has yet been carried out. In this prospective single-arm pilot trial, we administered lisinopril (0.4 mg/kg per day) as therapeutic treatment to 40 children with mild IgA-N with proteinuria [morning urinary protein/creatinine ratio (uP/Cr) ≥ 0.2 g/g]. Thirty-three patients reached the primary endpoint (uP/Cr < 0.2) during the 2-year treatment period. The cumulative disappearance rate of proteinuria determined by the Kaplan-Meier method was 80.9%. Mean uP excretion was reduced from 0.40 to 0.18 g/m2/day (p < 0.0001). Of the 40 patients treated, five (12.5%) showed dizziness, and four of these five needed the lisinopril dose reduced. However, lisinopril therapy was continued in all patients during the 2-year treatment period. No other side effect, such as cough, was observed. We conclude that the efficacy and safety of lisinopril is seemingly acceptable for the treatment of children with mild IgA-N.
AB - Even in children with mild immunoglobulin (Ig)A nephropathy (IgA-N) showing minimal/focal mesangial proliferation, persistent proteinuria seems to be a risk factor for progression of the disease, indicating the need for an effective and safe treatment even in such cases. Studies carried out to date have indicated that angiotensin-converting enzyme inhibitors (ACEIs) reduce urinary protein excretion and preserve renal function in adult IgA-N. However, no prospective study of ACEI only for childhood IgA-N has yet been carried out. In this prospective single-arm pilot trial, we administered lisinopril (0.4 mg/kg per day) as therapeutic treatment to 40 children with mild IgA-N with proteinuria [morning urinary protein/creatinine ratio (uP/Cr) ≥ 0.2 g/g]. Thirty-three patients reached the primary endpoint (uP/Cr < 0.2) during the 2-year treatment period. The cumulative disappearance rate of proteinuria determined by the Kaplan-Meier method was 80.9%. Mean uP excretion was reduced from 0.40 to 0.18 g/m2/day (p < 0.0001). Of the 40 patients treated, five (12.5%) showed dizziness, and four of these five needed the lisinopril dose reduced. However, lisinopril therapy was continued in all patients during the 2-year treatment period. No other side effect, such as cough, was observed. We conclude that the efficacy and safety of lisinopril is seemingly acceptable for the treatment of children with mild IgA-N.
KW - Angiotensin-converting enzyme inhibitor
KW - Focal mesangial proliferation
KW - Minimal change
KW - Proteinuria
KW - Renin-angiotensin system
KW - Urinary protein excretion
KW - Urinary protein to creatinine ratio
UR - http://www.scopus.com/inward/record.url?scp=61549092219&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=61549092219&partnerID=8YFLogxK
U2 - 10.1007/s00467-008-1006-8
DO - 10.1007/s00467-008-1006-8
M3 - Article
C2 - 18825420
AN - SCOPUS:61549092219
VL - 24
SP - 845
EP - 849
JO - Pediatric Nephrology
JF - Pediatric Nephrology
SN - 0931-041X
IS - 4
ER -