Authors: James C M Chan John D Mahan Howard Trachtman Jon Scheinman Joseph T Flynn Uri S Alon Marc B Lande Robert A Weiss Edward P Norkus
Publish Date: 2003/08/12
Volume: 18, Issue: 10, Pages: 1015-1019
Abstract
IgA nephropathy is the worlds most common primary glomerulonephropathy Recent evidence in a rat model implicated excessive production of oxygenfree radicals in the pathogenesis and suggested that vitamin Etreatment ameliorated progression We studied this antioxidant therapy on the glomerular filtration rate GFR proteinuria and hematuria in biopsyproven IgA nephropathy in children The duration of treatment or placebo was 2 years with vitamin E treatment consisting of 400 IU/day in children weighing 30 kg and twice that dose for those 30 kg We measured GFR at entry midpoint and exit At baseline and at 4month intervals after randomization urinary protein/creatinine ratios and urinalysis were examined The mixed model procedure with log transformation was used in data analysis to test treatment difference as well as the potential time effect Fiftyfive patients were randomized and 38 completed at least 1 year of followup At entry the clinical characteristics were not different between the treatment and placebo groups There was a trend toward better preservation of GFR in vitamin Etreated versus placebo patients 127±50 vs 112±31 ml/min/173 m2 respectively P=009 The urinary protein/creatinine ratio was significantly lower in the vitamin Etreated group vs placebo 024±038 vs 061±137 P0013 However there was no difference in the prevalence of hematuria between the groups Vitamin E treatment in our study patients was associated with significantly lower proteinuria but no effect on hematuria While there was a trend toward stabilization of GFR in the vitamin Etreated patients longterm treatment and followup are needed to determine whether antioxidant therapy is associated with preservation of renal function in IgA nephropathySung C Choi PhD Department of Biostatistics Virginia Commonwealth University Richmond VA provided statistical support The study was supported by grants from the National Institutes of Health R01 DK50419 DK97761 and the General Clinical Research Center M01 RR00065 HoffmanLaRoche Inc supplied vitamin E and placebo We thank KC Lin for research and Betty Timozek for secretarial support
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