Clinical Research About Anti-oxidants (Probucol)Combined With Valsartan In IgA Nephropathy

Background Angiotensin receptor antagonists (ARBs) and anti-oxidants reduce urinary protein excretion and delay progression of IgA nephropathy. We investigated the efficacy and safety of probucol (an anti-oxidant) combined with valsartan (an ARB) on the progression of IgA nephropathy.Methods Patients with IgA nephropathy (n=69) were recruited from5centers and randomly assigned to a treatment group (750mg/day probucol plus160mg/day valsartan) or a control group (160mg/day valsartan) and were followed for3years.Results At baseline, the two groups in any measured clinical information were comparable. The primary endpoint (doubling serum creatinine) showed no significant difference between the two groups during3year follow-up. The secondary endpoint (50%reduction in24-h urinary protein) occurred in23patients in the treatment group and20patients in the control group. The time to the secondary end-point was shorter in the treatment group than the control group (8.13months vs.19.63months,%=5.476, p0.019). However, at the3year follow-up, the24-h urinary protein levels were not significantly different from the baseline levels (1365.68±395.31mg/24h vs.1357.20±427.19mg/24h, respectively, F=1.101, P=0.298). At the1year follow-up, plasma cholesterol in the treatment group was markedly lower than in the control group (4.37±0.94mmol/L vs.4.87±0.80mmol/L,p=0.020). Conclusion Kidney function remained stable and no significant difference in two group patients. Probucol combined with valsartan led to a more rapid decrease of24-h urinary protein excretion than valsartan alone. However, the long-term effect needs further investigation.