Distinct Responses of Membranoproliferative Glomerulonephritis–Related Proteinuria to Spironolactone with and without Angiotensin II Blockade
Authors: Katsuhiko Yonemura
Journal: Annals of Internal Medicine (2003)

Letters4 November 2003Distinct Responses of Membranoproliferative Glomerulonephritis–Related Proteinuria to Spironolactone with and without Angiotensin II BlockadeKatsuhiko Yonemura, MD, PhD, Hideo Yasuda, MD, and Akira Hishida, MD, PHDKatsuhiko Yonemura, MD, PhDFrom Hamamatsu University School of Medicine; Hamamatsu, 431-3192 Japan.Search for more papers by this author, Hideo Yasuda, MDFrom Hamamatsu University School of Medicine; Hamamatsu, 431-3192 Japan.Search for more papers by this author, and Akira Hishida, MD, PHDFrom Hamamatsu University School of Medicine; Hamamatsu, 431-3192 Japan.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-9-200311040-00022-w3 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We report the cases of 2 nephrotic patients with idiopathic membranoproliferative glomerulonephritis in whom massive proteinuria was reduced after treatment with spironolactone. Four weeks of treatment with prednisolone, 40 mg/d, in addition to a low-salt diet, minimally reduced proteinuria in both patients, as is common in membranoproliferative glomerulonephritis. In contrast, the addition of spironolactone, 50 mg/d, over 3 weeks reduced proteinuria from 1.73 g/d to 0.58 g/d in patient 1, who had received candesartan and enalapril, and from 1.60 g/d to 1.04 g/d in patient 2, who did not receive an angiotensin-converting enzyme (ACE) inhibitor or an ...References1. Chrysostomou A, Becker G. Spironolactone in addition to ACE inhibition to reduce proteinuria in patients with chronic renal disease [Letter]. N Engl J Med. 2001;345:925-6. [PMID: 11565535] CrossrefMedlineGoogle Scholar2. Sato A, Hayashi K, Naruse M, Saruta T. Effectiveness of aldosterone blockade in patients with diabetic nephropathy. Hypertension. 2003;41:64-8. [PMID: 12511531] CrossrefMedlineGoogle Scholar3. Couture R, Regoli D. Vascular reactivity to angiotensin and noradrenaline in rats maintained on a sodium free diet or made hypertensive with desoxycorticosterone acetate and salt (DOCA/salt). Clin Exp Hypertens. 1980;2:25-43. [PMID: 7418541] CrossrefMedlineGoogle Scholar4. Schiffrin EL, Franks DJ, Gutkowska J. Effect of aldosterone on vascular angiotensin II receptors in the rat. Can J Physiol Pharmacol. 1985;63:1522-7. [PMID: 3006895] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Hamamatsu University School of Medicine; Hamamatsu, 431-3192 Japan. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAldosterone Blockade in Chronic Kidney DiseaseThe use of plasma aldosterone and urinary sodium to potassium ratio as translatable quantitative biomarkers of mineralocorticoid receptor antagonism 4 November 2003Volume 139, Issue 9Page: W-79KeywordsACE inhibitorsAldosteroneAngiotensin receptor blockerAttentionBlood plasmaBody weightCreatinineGlomerulonephritisProteinuriaRenal diseases ePublished: 4 November 2003 Issue Published: 4 November 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...