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Inhibitors of Angiotensin II in Proteinuric Mesangioproliferative Glomerulonephritis

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01115426
Recruitment Status : Completed
First Posted : May 4, 2010
Last Update Posted : May 4, 2010
Information provided by:
University Magna Graecia

Brief Summary:
This study evaluates prospectively the effects of an anti-angiotensin II regimen on renal outcome in patients with mesangioproliferative glomerulonephritis followed-up for 10 years.

Condition or disease Intervention/treatment Phase
IGA Glomerulonephritis Drug: Ramipril or losartan Phase 4

Detailed Description:
After signing informed consent, enrolled patients started treatment with ACEi. We decided to prescribe to all patients the same drug (ramipril) at the same dosage (5 mg/day). All patients were examined every 2 months during the first year of follow-up and every 6 months thereafter. At each visit, they underwent a complete physical examination. If the target blood pressure of <140/90 mmHg was not achieved with ramipril monotherapy, addition of other antihypertensive drug(s) was allowed. Patients complaining adverse side effects attributed to ramipril were switched to losartan (50 mg/day). The patients were also prescribed a normal protein (1 gram/kg/day) and moderately salt-restricted (6-8 grams/day) diet throughout the study.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 20 participants
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Long-term Treatment by Inhibitors of Angiotensin II at Low Doses in Non-nephrotic Proteinuric Patients With Pauciimmune and IgA Mesangioproliferative Glomerulonephritis
Study Start Date : January 1997
Actual Primary Completion Date : January 2007
Actual Study Completion Date : January 2008

Arm Intervention/treatment
anti-angiotensin II drugs
Never treated patients with non-nephrotic proteinuria (1-3 g/day), microhematuria, no-evidence of renal failure or other relevant diseases and with diagnosis of I-II stage IgA- or pauciimmune-MsPGN were considered eligible.
Drug: Ramipril or losartan
Ramipril (5 mg/day) was started soon after the enrollment and continued throughout the follow-up, having Losartan (50 mg/day) as alternative.
Other Name: renin-angiotensin system (RAS) inhibitors

Primary Outcome Measures :
  1. renal function and proteinuria [ Time Frame: at the end of first year of observation ]

    In particular, the end points of the study were a loss >20% of basal GFR and a decrease of basal daily proteinuria < 20% at the end of first year of observation.

    GFR was calculated using both the abbreviated Modification of Diet in Renal Disease (MDRD) study equation and measured creatinine clearance. For each patient, a time-averaged (TA) proteinuria were calculated as an average of the mean of every-6month period's 24-hour proteinuria measurements.

Secondary Outcome Measures :
  1. serum levels of creatinine [ Time Frame: at the end of first years of observation ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • proteinuria ≥ 1 g and < 3 g/24 hours stable during the 3 months of run-in
  • microscopic hematuria (with at least 10 red blood cells per high-power field), without other signs or symptoms of systemic diseases stable during the 3 months of run-in
  • no-evidence of renal failure or other relevant diseases
  • biopsy diagnosis of I-II stage IgA- or pauciimmune-MsPGN

Exclusion Criteria:

  • estimated Glomerular Filtration Rate (eGFR) <80 ml/min/1.73m2
  • previous immunosuppressive treatment
  • blood pressure (BP) >150/90 mmHg

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01115426

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"Mater Domini" Hospital
Catanzaro, Calabria, Italy, 88100
Sponsors and Collaborators
University Magna Graecia
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Study Chair: Giorgio Fuiano, Professor "Magna Graecia" University of Catanzaro, Nephrology Unit
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Pierangela Presta, "Magna Graecia" University of Catanzaro, Nephrology Unit Identifier: NCT01115426    
Other Study ID Numbers: IGAMsPGNPMsPGN
First Posted: May 4, 2010    Key Record Dates
Last Update Posted: May 4, 2010
Last Verified: January 1997
Additional relevant MeSH terms:
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Glomerulonephritis, IGA
Kidney Diseases
Urologic Diseases
Autoimmune Diseases
Immune System Diseases
Anti-Arrhythmia Agents
Antihypertensive Agents
Angiotensin II Type 1 Receptor Blockers
Angiotensin Receptor Antagonists
Molecular Mechanisms of Pharmacological Action
Angiotensin-Converting Enzyme Inhibitors
Protease Inhibitors
Enzyme Inhibitors