Comparison of the influence of angiotensin-converting enzyme inhibitor lisinopril and angiotensin II receptor antagonist losartan in patients with idiopathic membranous nephropathy and nephrotic syndrome

Kosmadakis, George; Filiopoulos, V.; Georgoulias, Christodoulos; Tentolouris, N.; Michail, S

doi:10.3109/00365591003667351

Cited by 11 publications

(7 citation statements)

References 23 publications

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“…Sublytic doses of C5b-9 can trigger a variety of intracellular signal transductions via C5b-9 binding to the plasma membrane of GECs ( [102]; reviewed in [103] and [104]). This treatment however appears to delay the progression of MN rather than prevent it [101] and as such, it is thought that ACEis and ARBs may not be the optimal therapy against proteinuria reduction and overall MN prevention [106]. Undoubtedly, inhibition of intracellular pathways responsible for podocyte injury, such as Nox activity and ROS (while important injury biomarkers and inducers) may be insufficient in MN prevention, as antibody production and GBM immune deposition would persistently trigger pathological responses in podocytes.…”

Section: Membranous Nephropathymentioning

confidence: 99%

Nox and renal disease

2014

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Since the first demonstration of Nox enzyme expression in the kidney in the early 1990s and the subsequent identification of Nox4, or RENOX, a decade later, it has become apparent that the Nox family of reactive oxygen species (ROS) generating enzymes plays an integral role in the normal physiological function of the kidney. As our knowledge of Nox expression patterns and functions in various structures and specialized cell types within the kidney grows, so does the realization that Nox-derived oxidative stress contributes significantly to a wide variety of renal pathologies through their ability to modify lipids and proteins, damage DNA and activate transcriptional programmes. Diverse studies demonstrate key roles for Nox-derived ROS in kidney fibrosis, particularly in settings of chronic renal disease such as diabetic nephropathy. As the most abundant Nox family member in the kidney, much emphasis has been placed on the role of Nox4 in this setting. However, an ever growing body of work continues to uncover key roles for other Nox family members, not only in diabetic kidney disease, but in a diverse array of renal pathological conditions. The objective of the present review is to highlight the latest novel developments in renal Nox biology with an emphasis not only on diabetic nephropathy but many of the other renal disease contexts where oxidative stress is implicated.

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Section: Membranous Nephropathymentioning

confidence: 99%

Nox and renal disease

2014

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“…The absence of a placebo control and the failure to include patents with higher-grade proteinuria (>8–10 g/d) weaken the impact of the study. 223 There is only low-quality evidence to support the value of other predictors, such as hypertension, histologic evidence of interstitial fibrosis and tubular atrophy, persistently elevated urinary C5b-9, and excretion of increased quantities of low- or high-molecular-weight proteins (β2-microglobulin and IgG) in urine. 224, 225 Staging of MN by histologic criteria has limited utility for prediction of outcomes or response to therapy in IMN.…”

Section: Rationalementioning

confidence: 99%

Chapter 7: Idiopathic membranous nephropathy

2012

Kidney International Supplements

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“…Results of Bayesian network analysis. First, proteinuria reduction was reported in all 14 trials (Acbay, 2001;Agha et al, 2009;Atmaca & Gedik, 2006;Horita et al, 2004;Kosmadakis et al, 2010;Maschio et al, 1994;Nakamura et al, 2007;Nakamura et al, 2002;Odabas et al, 2001;Ravid et al, 1993;Renke et al, 2004;Shen et al, 2012;Shimizu et al, 2008;Usta et al, 2003). The network map of eligible comparisons for proteinuria reduction is presented in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Third, a total of 6 studies were included for network analysis of GFR reduction (Acbay, 2001;Horita et al, 2004;Kosmadakis et al, 2010;Shen et al, 2012;Shimizu et al, 2008;Usta et al, 2003). Rank N reduced GFR the least, suggesting the best renoprotective effect.…”

Section: Proteinuria Reduction Bp Reduction Egfr Reductionmentioning

confidence: 99%

Comparative proteinuria management of different angiotensin-converting enzyme inhibitors or angiotensin receptor blockers for normotensive patients with CKD: a Bayesian network meta-analysis

Huo

et al. 2020

PeerJ

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Background Both angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are blood pressure-lowering agents, but they are also being used to control proteinuria in early chronic kidney disease (CKD) patients. However, clinically, some patients present merely proteinuria without hypertension. No guidelines pointed out how to select treatments for proteinuria in normotensive patients. Thus, we conducted a Bayesian network analysis to evaluate the relative effects of different kinds of ACEI or ARB or their combination on proteinuria and blood pressure reduction. Methods The protocol was registered in PROSPERO with ID CRD42017073721. A comprehensive literature database query was carried out systematically according to PICOS strategies. The primary outcome was reduction in proteinuria, and the secondary outcomes were eGFR reduction and blood pressure reduction. Random-effects pairwise and Bayesian network meta-analyses were used to estimate the effect of different regimens. Results A total of 14 RCTs with 1,098 patients were included in the analysis. All treatment strategies of ACEI, ARB or their combination had significantly greater efficacy in reducing proteinuria than placebo in normotensive CKD patients. The combination therapy of olmesartan+temocapril had the highest probability (22%) of being the most effective treatment to reduce proteinuria in normotensive CKD patients. Olmesartan and lisinopril ranked second (12%), and temocapril ranked third (15%) but reduced blood pressure less than placebo. For IgA nephropathy, the combination therapy of olmesartan+temocapril also had the highest probability (43%) of being the best antiproteinuric treatment, while enalapril had the highest probability (58%) of being the best antiproteinuric therapy for diabetic nephropathy. Conclusions The combination therapy of olmesartan plus temocapril appeared to be the most efficacious for reducing proteinuria in normotensive CKD patients and IgA nephropathy, but the clinical application should be balanced against potential harms. Temocapril can be an option when practitioners are searching for more proteinuria reduction but less blood pressure variation. In normotensive diabetic nephropathy, monotherapy with the ACEI enalapril seems to be the most efficacious intervention for reducing albuminuria. Future studies are required to give a more definitive recommendation.

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Comparison of the influence of angiotensin-converting enzyme inhibitor lisinopril and angiotensin II receptor antagonist losartan in patients with idiopathic membranous nephropathy and nephrotic syndrome

Abstract: Treatment with lisinopril and losartan in nephrotic patients with idiopathic membranous nephropathy results in similar (and significant) effects on renal function, hypoalbuminaemia, proteinuria and blood pressure.

Cited by 11 publications

References 23 publications

Nox and renal disease

Nox and renal disease

Chapter 7: Idiopathic membranous nephropathy

Comparative proteinuria management of different angiotensin-converting enzyme inhibitors or angiotensin receptor blockers for normotensive patients with CKD: a Bayesian network meta-analysis

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