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Comparison of the effects of valsartan plus activated vitamin D versus valsartan alone in IgA nephropathy with moderate proteinuria

  • Nephrology - Original Paper
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Abstract

Background/aims

To compare the effects of valsartan plus activated vitamin D with valsartan alone on urinary protein excretion and eGFR in IgA nephropathy with moderate proteinuria.

Methods

A prospective, single-center, randomized, controlled study was performed between Jan, 2008 and Jan, 2018 on patients with IgA nephropathy who had moderate proteinuria with urinary protein excretion 1.0–3.0 g/24 h. These IgAN patients were randomly assigned to receive either valsartan 160 mg/day treatment or valsartan 160 mg/day plus activated vitamin D (calcitriol) 0.5 μg/day treatments. The changes of the clinical, biochemical data, and the adverse events during the observation period were all analyzed in the two groups. The primary endpoint was defined as changes in urinary protein excretion at week 24 compared with the baseline and the secondary endpoint was to observe the changes in estimated glomerular filtration rate (eGFR) between baseline and the end of the study.

Results

Baseline characteristics between the two groups were comparable. At the end of the treatment period, urinary protein excretion in both two groups decreased significantly (P < 0.05). However, there was a more significant decrease in proteinuria in IgAN patients who received valsartan plus activated vitamin D treatment (from 2.39 ± 0.77 to 1.43 ± 0.57 g/24 h, P < 0.01) compared to valsartan treatment alone (from 2.46 ± 0.81 to 1.78 ± 0.60 g/24 h, P < 0.05). The percentage change in urine protein excretion at week 24 was  − 40.2% in valsartan plus activated vitamin D treatment group (P < 0.01) and − 27.6% in valsartan treatment group (P < 0.05). No significant change in blood pressure, estimated glomerular filtration rate, serum calcium, and serum potassium was observed. The incidence of adverse events was similar between the two groups, respectively (P > 0.05).

Conclusion

Combination therapy with valsartan plus activated vitamin D is more effective than valsartan alone in reduction of moderate proteinuria in IgA nephropathy and without more adverse events.

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Acknowledgements

The authors express their gratitude to all colleagues and collaborators who participated in this study.

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Authors and Affiliations

  1. Department of Nephrology, Xijing Hospital, Fourth Military Medical University, No. 127 West Changle Road, Xi’an, 710032, Shaanxi Province, China

    Liu Xiaowei, Li Li & Zhang Peng

  2. Department of Clinical Epidemiology, Fourth Military Medical University, Xi’an, 710032, Shaanxi Province, China

    Wang Bo

Authors
  1. Liu Xiaowei
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  2. Wang Bo
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  3. Li Li
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  4. Zhang Peng
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Contributions

WB designed the research, interpreted data, and performed statistical analysis; LX designed the research, interpreted data, and wrote the manuscript; LL collected samples and analyzed samples; ZP designed the research, identified sample characteristics, and reviewed the manuscript.

Corresponding author

Correspondence to Zhang Peng.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies were got approval from the Ethics Committee of XiJing hospital affiliated to Fourth Military Medical University (clinical trial registration number XJ20070047) according to the 1964 Helsinki Declaration and its latter amendments or comparable ethical standards.

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Informed consent was signed from all participants included in the study.

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Xiaowei, L., Bo, W., Li, L. et al. Comparison of the effects of valsartan plus activated vitamin D versus valsartan alone in IgA nephropathy with moderate proteinuria. Int Urol Nephrol 52, 129–136 (2020). https://doi.org/10.1007/s11255-019-02329-5

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  • DOI: https://doi.org/10.1007/s11255-019-02329-5

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