Linked Life Data

18360019

Source:http://linkedlifedata.com/resource/pubmed/id/18360019

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2008-3-24
pubmed:abstractText
Although dual blockade of the renin-angiotensin-aldosterone system (RAAS) with the combination of an angiotensin-converting enzyme inhibitor (ACE-I) and angiotensin II receptor blocker (ARB) is generally well-established as a treatment for nephropathy, this treatment is not fully effective in some patients. Based on the recent evidence implicating aldosterone in renal disease progression, this study was conducted to examine the efficacy of blockade with three different mechanisms by adding an aldosterone blocker in patients who do not respond adequately to the dual blockade. A 1-year randomized, open-label, multicenter, prospective controlled study was conducted, in which 32 non-diabetic nephropathy patients with proteinuria exceeding 0.5 g/day were enrolled after more than 12 weeks of ACE-I (5 mg enalapril) and ARB (50 mg losartan) combination treatment. These patients were allocated into two groups of 16 patients each: a triple blockade group in which 25 mg of spironolactone daily was added to the ACE-I and ARB combination treatment, and a control group in which 1 mg of trichlormethiazide or 20 mg of furosemide was added to the combination treatment instead of spironolactone depending upon the creatinine level. After 1 year of treatment, the urinary protein level decreased by 58% (p<0.05) with the triple blockade but was unchanged in the controls. Furthermore, urinary type IV collagen level decreased by 40% (p<0.05) with the triple blockade but was unchanged in the controls. The decreases in urinary protein and urinary type IV collagen were not accompanied by a decrease in blood pressure. Mean serum creatinine, potassium and blood pressure did not change significantly by either treatment. In conclusion, triple blockade of the RAAS was effective for the treatment of proteinuria in patients with non-diabetic nephropathy whose increased urinary protein had not responded sufficiently to a dual blockade.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jan
pubmed:issn
0916-9636
pubmed:author
pubmed:issnType
Print
pubmed:volume
31
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
59-67
pubmed:meshHeading
pubmed-meshheading:18360019-Aldosterone Antagonists, pubmed-meshheading:18360019-Angiotensin II Type 1 Receptor Blockers, pubmed-meshheading:18360019-Angiotensin-Converting Enzyme Inhibitors, pubmed-meshheading:18360019-Blood Pressure, pubmed-meshheading:18360019-Collagen Type IV, pubmed-meshheading:18360019-Disease Progression, pubmed-meshheading:18360019-Diuretics, pubmed-meshheading:18360019-Drug Therapy, Combination, pubmed-meshheading:18360019-Female, pubmed-meshheading:18360019-Humans, pubmed-meshheading:18360019-Kidney Diseases, pubmed-meshheading:18360019-Kidney Function Tests, pubmed-meshheading:18360019-Male, pubmed-meshheading:18360019-Middle Aged, pubmed-meshheading:18360019-Plasminogen Activator Inhibitor 1, pubmed-meshheading:18360019-Potassium, pubmed-meshheading:18360019-Prospective Studies, pubmed-meshheading:18360019-Proteinuria, pubmed-meshheading:18360019-Renin-Angiotensin System, pubmed-meshheading:18360019-Spironolactone, pubmed-meshheading:18360019-Thiazides, pubmed-meshheading:18360019-Transforming Growth Factor beta1
pubmed:year
2008
pubmed:articleTitle
Effect of renin-angiotensin-aldosterone system triple blockade on non-diabetic renal disease: addition of an aldosterone blocker, spironolactone, to combination treatment with an angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker.
pubmed:affiliation
Department of Kidney Disease and Hypertension, Osaka General Medical Center, Japan.
pubmed:publicationType
Journal Article, Randomized Controlled Trial, Multicenter Study