Search:
  高级检索   全部    有全文
现在位置: 首页 > 检索 >期刊论文 > 
Antiproteinuric effect of add-on paricalcitol in CKD patients under maximal tolerated inhibition of renin-angiotensin system: a prospective observational study
Roberto Minutolo; Domenico Russo; Giuseppe Conte; Antonio Gorini; Luca De Nicola
BMC Nephrology,13,1(2012-11-20)
原文下载:

摘要:

Background

Whether paricalcitol (PCT) reduces proteinuria in the presence of intensified inhibition of Renin-Angiotensin-System (RAS) is poorly studied. We evaluated the antiproteinuric effect of PCT in non-dialysis chronic kidney disease (CKD) patients with proteinuria greater than 0.5 g/24 h persisting despite anti-RAS therapy titrated to minimize proteinuria in the absence of adverse effects.

Methods

Forty-eight CKD patients were studied in the first six months of add-on oral PCT (1 mcg/day) and three months after drug withdrawal.

Results

Males were 87.5%, age 63????????14 yrs, systolic/diastolic blood pressure (BP) 143????????22/78????????11 mmHg, eGFR 29.7????????14.5 mL/min/1.73 m2, diabetes 40%, and cardiovascular disease 38%. At referral in the center (28 months prior to study baseline), proteinuria was 2.44 (95% CI 1.80-3.04) g/24 h with 6 patients not receiving any anti-RAS and 42 treated with a single agent, at low dosage in most cases. At study baseline, twenty patients were under 2???3 anti-RAS drugs while twenty-eight received 1 agent at full dose and proteinuria resulted to be reduced versus referral to 1.23 g/24 h (95%CI 1.00-1.51). Six months of add-on PCT significantly decreased proteinuria to 0.61 g/24 h (95%CI 0.40-0.93), with levels less than 0.5 g/24 h achieved in 37.5% patients, in the absence of changes of BP and GFR. Proteinuria recovered to basal value after drug withdrawal. The extent of antiproteinuric response to PCT was positively associated with diabetes, eGFR and daily Na excretion (R2???=???0.459, P???<???0.0001). PTH decreased from 201 (IQR 92???273) to 83 (IQR 50???189) pg/mL.

Conclusions

In CKD patients, add-on PCT induces a significant reduction of proteinuria that is evident despite intensified anti-RAS therapy and larger in the presence of diabetes, higher GFR and unrestricted salt intake.

关键词:Angiotensin II receptor blocker, Angiotensin converting enzyme inhibitor, Renin inhibitor, Proteinuria, Chronic kidney disease, Paricalcitol

出版者:BioMed Central Ltd
出版日期:2012-11-20
资源类型:期刊论文
学科分类:Urology;Nephrology
语种:en
授权许可:http://creativecommons.org/licenses/by/2.0/
本地全文:http://gooa.las.ac.cn/external/index?type=-1&pid=1083061
内容提供者:开放获取论文一站式发现平台(GoOA)

推荐引用方式:Roberto Minutolo,Domenico Russo,Giuseppe Conte, et al. Antiproteinuric effect of add-on paricalcitol in CKD patients under maximal tolerated inhibition of renin-angiotensin system: a prospective observational study[J]. BMC Nephrology,2012,13(1)

浏览量:395    下载量:1