Korean Journal of Nephrology 2007;26(5):541-547.
Effects of Spironolactone on the Urinary Excretion of TGF-β1 in IgA Nephropathy
Kyung-Hwan Jeong, M.D., Mina Park, M.D., Joo-Young Moon, M.D. Sang-Ho Lee, M.D., Tae-Won Lee, M.D. and Chun-Gyoo Ihm, M.D
Department of internal medicine, College of Medicine, Kyung Hee University
IgA 신증에서 spironolactone이 요중 TGF-β1 분비에 미치는 효과
정경환 박미나 문주영 이상호 이태원 임천규
경희대학교 의과대학 내과학교실
Abstract
Purpose : Transforming growth factor-β1 (TGF-β1) has an important role in the pathogenesis of renal damage; it enhances extracellular matrix production. Urinary TGF-β1 excretion has been shown to be significantly increased in patients with IgA nephropathy. The aim of the present study was to evaluate the effect of spironolactone on urinary TGF-β1 levels in patients with IgA nephropathy. Methods : TGF-β1 was measured by enzyme-linked immunosorbent assay in random urine specimens from 35 patients with IgA nephropathy. The patients were assigned to a spironolactone group, prednisolone group or losartan group. They were treated over an 8-week period. Urine samples were tested at the beginning and the end of the treatment period. Results : The patients with IgA nephropathy (n=35) had a higher urinary excretion of TGF-β1 than normal controls (n=13). Urinary TGF-β1 excretion was positively correlated with proteinuria and pathological grading but not with serum creatinine. After 8 weeks of treatment, losartan (n=13) and prednisolone (n=11) therapy induced a significant reduction in both urinary protein and TGF-β1 excretion. After treatment with spironolactone (n=11), urinary protein and TGF-β1 excretion were decreased. However, the decrease was not statistically significant. There was a significant correlation between the urinary TGF-β1 excretion and the serum aldosterone (r=0.84; p<0.01); however, treatment with spironolactone abolished this correlation. Conclusion : This study provides evidence that endogenous aldosterone influences urinary TGF-β1 excretion in patients with IgA nephropathy.
Key Words: Glomerulonephritis, IgA, Transforming growth factor beta 1, Spironolactone
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