Maximal suppression of renin-angiotensin system in nonproliferative glomerulonephritis

摘要: Maximal suppression of renin-angiotensin system in nonproliferative glomerulonephritis. Background Elimination residual proteinuria is the novel target renoprotrection; nevertheless, whether a greater (RAS) effectively improves antiproteinuric response patients with moderate remains ill-defined. Methods We evaluated effects maximizing RAS on quantitative and qualitative ten stable nonnephrotic (2.55 ± 0.94 g/24 hours) due to primary glomerulonephritis (NPGN), normal values creatinine clearance (103 17 mL/min). The study was divided three consecutive phases: ( 1 ) four subsequent 1-month periods ramipril at dose 2.5, 5.0, 10, 20 mg/day; 2 months mg/day + irbesartan 300 3 alone. Results Maximizing not coupled any major effect renal function blood pressure; conversely, significant decrement hemoglobin levels, 0.8 g/dL average, observed during up-titration dose. 2.5 mg significantly decreased by 29%. Similar changes were detected after alone (-28%). improved either higher doses (-30% dose) or combined treatment (-33%). reduction led amelioration markers tubular damage, as testified α microglobulin (α m) excretion component sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Conclusion In NPGN patients, standard lead features suggestive damage. enhancement up maximal degree does improve levels.