Vitamin E therapy in IgA nephropathy: a double-blind, placebo-controlled study
Scheinman, Jon; Mahan, John D.; Alon, Uri S.; Norkus, Edward P.; Lande, Marc B.; Weiss, Robert A.; Trachtman, Howard; Flynn, Joseph T.; Chan, James C. M.
2003-10
Citation
Chan, James C. M.; Mahan, John D.; Trachtman, Howard; Scheinman, Jon; Flynn, Joseph T.; Alon, Uri S.; Lande, Marc B.; Weiss, Robert A.; Norkus, Edward P.; (2003). "Vitamin E therapy in IgA nephropathy: a double-blind, placebo-controlled study." Pediatric Nephrology 18(10): 1015-1019. <http://hdl.handle.net/2027.42/47819>
Abstract
IgA nephropathy is the world's most common primary glomerulonephropathy. Recent evidence in a rat model implicated excessive production of oxygen-free radicals in the pathogenesis and suggested that vitamin E-treatment ameliorated progression. We studied this antioxidant therapy on the glomerular filtration rate (GFR), proteinuria and hematuria in biopsy-proven IgA nephropathy in children. The duration of treatment or placebo was 2 years, with vitamin E treatment consisting of 400 IU/day in children weighing <30 kg, and twice that dose for those >30 kg. We measured GFR at entry, midpoint and exit. At baseline and at 4-month intervals after randomization, urinary protein/creatinine ratios and urinalysis were examined. The mixed model procedure with log transformation was used in data analysis to test treatment difference as well as the potential time effect. Fifty-five patients were randomized and 38 completed at least 1 year of follow-up. At entry, the clinical characteristics were not different between the treatment and placebo groups. There was a trend toward better preservation of GFR in vitamin E-treated versus placebo patients, 127±50 vs. 112±31 ml/min/1.73 m 2 , respectively ( P =0.09). The urinary protein/creatinine ratio was significantly lower in the vitamin E-treated group vs. placebo; 0.24±0.38 vs. 0.61±1.37 ( P <0.013). However, there was no difference in the prevalence of hematuria between the groups. Vitamin E treatment in our study patients was associated with significantly lower proteinuria, but no effect on hematuria. While there was a trend toward stabilization of GFR in the vitamin E-treated patients, long-term treatment and follow-up are needed to determine whether antioxidant therapy is associated with preservation of renal function in IgA nephropathy.Publisher
Springer-Verlag; IPNA
ISSN
0931-041X 1432-198X
Other DOIs
PMID
12920628
Types
Article
URI
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=12920628&dopt=citationMetadata
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