@article{oai:twinkle.repo.nii.ac.jp:00018850,
 author = {WATANABE, Yoshiko and HONDA, Kazuho and UCHIDA, Keiko and NITTA, Kosaku and NIHEI, Hiroshi},
 issue = {1/2},
 journal = {東京女子医科大学雑誌},
 month = {Feb},
 note = {IgA腎症患者に対するアンジオテンシン受容体拮抗薬(ARB)の蛋白尿減少効果を,男性7例,女性10例の計17症例で検討した.このうち,15例はlosartanで,2例はcandesartanで加療した.加療後,30%以上の蛋白尿減少を認めた群をresponder(R)群,それ以外をnon-responder(NR)群としたところ,R群は9例,NR群は8例であった.両群間にステロイドやACE阻害薬の併用など,臨床上の有意差は認めなかった.また,病理組織学的にも両群間に有意差を認めなかった.一方,R群ではARBの治療前後において,平均血圧(MAP)を有意に低下させたが,NR群では降圧効果を認めなかった.また,ARBによる降圧効果と蛋白尿減少効果は相関することも明らかになった.以上より,ARBはlgA腎症患者に対し,血圧に依存して蛋白尿を減少させると考えられる., The aim of the present study was to examine the antiproteinuric effects of two angiotensin II receptor blockers (ARB), losartan and candesartan, in patients with IgA nephropathy. Seventeen patients (7 men and 10 women; mean age, 43.2 ± 12.9 years) were enrolled in this study. Fifteen patients was given 12.5～100 mg/day of losartan, and two patients ware given 2～8 mg/day of candesartan. Nine patients responded to the treatment (R group) and 8 patients did not (NR group). The clinical parameters, including the percentage of patients who also received steroid or angiotensin-converting enzyme inhibitor combination therapy, were not significantly different between the groups. The administration of an ARB significantly reduced the proteinuria from a basal value of 1.0 ± 0.4 g/day to 0.4 ± 0.4 g/day (p<0.05), with this effect appearing 3.0 ± 2.2 months after the start of treatment. An additional reduction in proteinuria was observed when the ARB dose was increased in the R group, but this effect was not observed in the NR group. Moreover, the ARB treatment significantly reduced the mean arterial pressure (MAP) from a basal value of 98.2 ± 12.8 mmHg to 90.5 ± 13.3 mmHg in the R group (p<0.05). However, the MAP remained unchanged throughout the study in the NR group (93.8 ± 16.8 vs. 99.6 ± 10.7 mmHg). After the ARB treatment, a weak but significant correlation was found when the MAPs were compared with the levels of proteinuria (r=0.271, p=0.024). Finally, no significant difference in the pathological factors of the two groups was observed. In conclusion, our study shows that, the addition of an ARB to the conventional therapy for IgA nephropathy has an additive anti-proteinuric effect that is related to a reduction in blood pressure.},
 pages = {14--21},
 title = {Therapeutic Effect of Angiotensin Receptor Antagonist on Patients with IgA Nephropathy},
 volume = {73},
 year = {2003}
}