Comparative Study Of The Efficacy Of Irbesartan And Perindopril On Proteinuria In Patients With Membranous Nephropathy

Objectives:To compare the efficacy of irbesartan(ARB)and perindopril(ACE inhibitor)in the reduction of proteinuria in membranous nephropathy and to explore the corresponding mechanism.Methods:This is a prospective study.Patients were recruited from the Department of Nephrology at the Yan'an Hospital Affiliated to Kunming Medical University from January 2018 to June 2019,complete clinical history of patients was obtained and 22 patients diagnosed as membranous nephropathy by renal biopsy were included in this study.Patients were then randomly divided into two groups:12 patients in the irbesartan group and 10 patients in the perindopril group.Based on the routine treatment of membranous nephropathy(steroids and immunosuppressants),patients were treated with irbesartan(ARB)and perindopril(ACE I)for 3 months.The changes in 24-hour urine protein,serum albumin,serum creatinine,triglycerides,and cholesterol were observed and the differences between the two groups were analyzed.Results:(1)Among 22 patients,14 patients(63.64%)were male and 8 patients(36.36%)were female.The mean age was 58.14±8.99 years.Edema was present in 18 patients(81.81%)and absent in 4 patients(18.18%).(2)According to the treatment given,patients were divided into two groups,12 patients(54.5%)in the irbesartan group and 10 patients(45.4%)in the perindopril group.The perindopril group had more male patients(90%)and the irbesartan group had an equal number of male and female patients.(3)Treatment with irbesartan and perindopril was followed up after 3 months,there was a decrease in 24-hour urine protein in both groups,and a similar decrease was found when compared between the two groups,with no statistical significance(P>0.05).Conclusion(s):In the 3 months follow-up from the baseline,24-hour urine protein excretion decreased in both groups,but there was no statistical significance,indicating that irbesartan and perindopril had similar effects in reducing proteinuria,and the overall effect was not significant.This is a short-term study,so long-term study for comparison of efficacy with extended follow-up and the larger sample size is required to reach scientific and reasonable conclusions.