| Literature DB >> 19629623 |
Satoru Kuriyama1, Naoki Sugano, Hiroyuki Ueda, Yasushi Otsuka, Go Kanzaki, Tatsuo Hosoya.
Abstract
A patient with chronic kidney disease (CKD) due to membranous nephropathy with daily urinary protein excretion exceeding 5 g did not respond well to dual therapy with an angiotensin converting enzyme inhibitor (ACE-I) and angiotensin II receptor blocker (ARB). Addition of the mineralocorticoid receptor blocker (MRB), spironolactone, led to moderate reduction in daily urinary protein excretion. However, spironolactone had to be inevitably discontinued due to gynecomastia. Replacement of spironolactone with the selective MRB, eplerenone, added to the preceding treatment with ACE-I and ARB, resulted in remarkable reduction of daily urinary protein excretion to less than 0.2 g. This case suggests that triple blockade of renin-angiotensin-aldosterone (RAA) system with ACE-I, ARB, and MRB could be useful for CKD patients with massive proteinuria.Entities:
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Year: 2009 PMID： 19629623 DOI： 10.1007/s10157-009-0213-3
Source DB: PubMed Journal: Clin Exp Nephrol ISSN： 1342-1751 Impact factor: 2.801