Vitamin E Therapy in IgA Nephropathy: A Double-Blind Placebo-Controlled Study
Document Type
Article
Publication Date
10-1-2003
Description
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 m2, 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, longterm treatment and follow-up are needed to determine whether antioxidant therapy is associated with preservation of renal function in IgA nephropathy.
Citation Information
Chan, James C.M.; Mahan, John D.; Trachtman, Howard; Scheinman, Jon; Flynn, Joseph T.; Alon, Uri S.; Lande, Marc B.; Weiss, Robert A.; and Norkus, Edward P.. 2003. Vitamin E Therapy in IgA Nephropathy: A Double-Blind Placebo-Controlled Study. Pediatric Nephrology. Vol.18(10). 1015-1019. https://doi.org/10.1007/s00467-003-1205-2 PMID: 12920628 ISSN: 0931-041X