Nakamura T, Ushiyama C, Takahashi Y, Tanaka A, Shimada N, Ebihara I, Koide H
Department of Medicine, Misato Junshin Hospital, Misato, Japan.
Nephron. 2001 May;88(1):80-2. doi: 10.1159/000045963.
Proteinuria and microalbuminuria occur with a highly variable severity and are associated with progression of autosomal dominant polycystic kidney disease (ADPKD). Dilazep dihydrochloride, an antiplatelet drug, is effective in patients with immunoglobulin A nephropathy or diabetic nephropathy. We studied whether dilazep dihydrochloride affects the urinary albumin excretion (UAE) in normotensive and hypertensive patients with ADPKD. Twelve normotensive ADPKD patients with microalbuminuria were randomly assigned to two groups: a dilazep (300 mg/day) treatment group (n = 6, group A) and a placebo group (n = 6, group B). In addition, 10 hypertensive ADPKD patients with microalbuminuria were randomly assigned to two groups: a dilazep (300 mg/day) treatment group (n = 5, group C) and a placebo group (n = 5, group D). Treatment with dilazep was continued for a period of 6 months, at the end of which the UAE was reduced form 130 +/- 52 to 46 +/- 26 microg/min (p < 0.01) in group A. There was no reduction in group C. There were no changes in UAE in placebo groups B and D. These results suggest that dilazep dihydrochloride may be effective in reducing UAE in normotensive ADPKD patients with microalbuminuria.
蛋白尿和微量白蛋白尿的严重程度差异很大,且与常染色体显性多囊肾病(ADPKD)的进展相关。抗血小板药物盐酸地拉齐普对免疫球蛋白A肾病或糖尿病肾病患者有效。我们研究了盐酸地拉齐普是否会影响血压正常和高血压的ADPKD患者的尿白蛋白排泄量(UAE)。12例血压正常且有微量白蛋白尿的ADPKD患者被随机分为两组:地拉齐普(300毫克/天)治疗组(n = 6,A组)和安慰剂组(n = 6,B组)。此外,10例有微量白蛋白尿的高血压ADPKD患者被随机分为两组:地拉齐普(300毫克/天)治疗组(n = 5,C组)和安慰剂组(n = 5,D组)。地拉齐普治疗持续6个月,治疗结束时,A组的UAE从130±52降至46±26微克/分钟(p < 0.01)。C组没有降低。安慰剂组B和D的UAE没有变化。这些结果表明,盐酸地拉齐普可能对降低血压正常且有微量白蛋白尿的ADPKD患者的UAE有效。