Influence of irbesartan on the urinary excretion of cytokines in patients with chronic kidney disease

Chinese Medical Journal, 04/10/2012

Jie N et al. – Irbesartan offers additional renoprotection in a dose–dependent manner by reducing pro–inflammatory cytokines excretion in the urine of chronic kidney disease (CKD) patients.

Methods

  • In this randomized perspective clinical trial, different doses of irbesartan (150 mg/d and 300 mg/d) were given to two groups of patients in a cross–over design.
  • Blood pressure (BP), creatinine clearance (Ccr) and 24–hour proteinuria were examined.
  • Urinary excretion of cytokines was determined by human inflammatory cytokine antibody array.
  • A two–fold change in spot intensity was considered significant.

Results

  • Urinary excretion of cytokines (granulocyte colony stimulating factor (GCSF), intercellular cell adhesion molecule–1 (ICAM–1), interferon γ (IFN– γ), interleukin 1 β (IL–1b), IL–2, IL–6, IL–8, IL–11, IL–15 and macrophage inflammatory protein 1d (MIP–1d)) in group B (irbesartan 300 mg/d) was significantly decreased in comparison to group A (irbesartan 150 mg/d) after 8–week treatment.
  • In group A, 8 weeks of treatment induced a two– to nine–fold reduction in urinary cytokine levels (GCSF, GM–CSF, IFN– γ, IL–1a, IL–11, IL–12p40, MCP–2, MIP–1a), while increasing the dosage to 300 mg/d further decreased the excretion of GCSF, GM–CSF, IL–12p40, MCP–2 and MIP–1a by week 18.
  • There was no significant difference in BP or Ccr between the two groups.
  • However, 24–hour proteinuria was significantly reduced in both groups, and in group A the reduction was dose dependent.

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