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03.10.2018 | Original Article

Lisinopril versus lisinopril and losartan for mild childhood IgA nephropathy: a randomized controlled trial (JSKDC01 study)

verfasst von: Yuko Shima, Koichi Nakanishi, Mayumi Sako, Mari Saito-Oba, Yuko Hamasaki, Hiroshi Hataya, Masataka Honda, Koichi Kamei, Kenji Ishikura, Shuichi Ito, Hiroshi Kaito, Ryojiro Tanaka, Kandai Nozu, Hidefumi Nakamura, Yasuo Ohashi, Kazumoto Iijima, Norishige Yoshikawa, for the Japanese Study Group of Kidney Disease in Children (JSKDC)

Erschienen in: Pediatric Nephrology | Ausgabe 5/2019

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Abstract

Background

Persistent proteinuria seems to be a risk factor for progression of renal disease. Its reduction by angiotensin-converting inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) is renoprotective. Our previous pilot study showed that 2-year lisinopril therapy is effective and safe for children with mild IgA nephropathy. When combined with ACEI and ARB, reported results are of greater decrease in proteinuria than monotherapy in chronic glomerulonephritis, including IgA nephropathy. To date, however, there have been no randomized controlled trials in children.

Methods

This is an open-label, multicenter, prospective, and randomized phase II controlled trial of 63 children with biopsy-proven proteinuric mild IgA nephropathy. We compared efficacy and safety between patients undergoing lisinopril monotherapy and patients undergoing combination therapy of lisinopril and losartan to determine better treatment for childhood proteinuric mild IgA nephropathy.

Results

There was no difference in proteinuria disappearance rate (primary endpoint) between the two groups (cumulative disappearance rate of proteinuria at 24 months: 89.3% vs 89% [combination vs monotherapy]). Moreover, there were no significant differences in side effects between the two groups.

Conclusions

We propose lisinopril monotherapy as treatment for childhood proteinuric mild IgA nephropathy as there are no advantages of combination therapy.

Clinical trial registration

Clinical trial registry, UMIN ID C000000006, https://www.umin.ac.jp.

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Titel: Lisinopril versus lisinopril and losartan for mild childhood IgA nephropathy: a randomized controlled trial (JSKDC01 study)
verfasst von: Yuko Shima
Koichi Nakanishi
Mayumi Sako
Mari Saito-Oba
Yuko Hamasaki
Hiroshi Hataya
Masataka Honda
Koichi Kamei
Kenji Ishikura
Shuichi Ito
Hiroshi Kaito
Ryojiro Tanaka
Kandai Nozu
Hidefumi Nakamura
Yasuo Ohashi
Kazumoto Iijima
Norishige Yoshikawa
for the Japanese Study Group of Kidney Disease in Children (JSKDC)
Publikationsdatum: 03.10.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Nephrology / Ausgabe 5/2019
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-018-4099-8

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Lisinopril versus lisinopril and losartan for mild childhood IgA nephropathy: a randomized controlled trial (JSKDC01 study)