Influence Of Double Dose Losartan On Urinary Connective Tissue Growth Factor Excretion In Primary Chronic Glomerulonephropathy

【Objective】Renal fibrosis is the common pathway of a variety of progressive renal disease to the end stage renal fairlure(ESRF). Connective tissue growth factor (CTGF) is an important profibrotic cytokine implicated in development of chronic renal disease. Urinary CTGF is reported to significantly increased in patients with diabetic nephropathy. We have shown that the renal expression of CTGF is greatly up-regulated in diabetic rats and angiotensin II receptor antagonis(tARA)inhibited the expression of CTGF and angiotensin II (AngⅡ)induced a time and dose-dependent expression of CTGF mRNA in human proximal tubular epithelial cells(HPTC). As an early marker, we therefore investigated the influence of double doses Losartan on urinary CTGF excretion and to explore change and significance of urinary CTGF in patients with primary chronic glomerulonephropathy(PCG).【Methods】Urine samples from 15 patients with biopsy-proven primary glomerulonephropathy from December 2004 to December 2005 in the affiliated Zhongda hospital of Southeast University. These patients'creatinine clearance (CCr)were more than 30ml/min per 1.73m2 with proteinuria ranging from 1-3g/d. They were randomly divided into two group: groupA(n=8)and groupB(n=7).After a washout period of one week, groupA patients received Losartan 50mg once daily meanwhile group B received Losartan 100mg once daily in treatment periods, with a total follow-up time of 8 weeks. At baseline, after 4 weeks and 8 weeks, urinary CTGF levels[enzyme linked immonosorbent assay(ELISA)], 24h proteinuria, creatinine clearance (Ccr) and blood pressure were determined. Renal CTGF expression were determined by immunohistochemistry.【Results】Two group baseline 24h proteinuria,creatinine clearance(Ccr),blood pressure,expression of CTGF in kidney and score of renal fibrosis were no difference (P>0.05 respectively), and levels of urinary CTGF were no difference too(40.51±20.12 vs 27.96±...