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.
- 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.