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Vitamin E therapy in IgA nephropathy: a double-blind, placebo-controlled study
James C M Chan1, John D Mahan, Howard Trachtman
1Virginia Commonwealth University, Richmond, Virginia, USA. chanj@mmc.org
Pediatric Nephrology (Berlin, Germany)
|August 16, 2003
Summary
Vitamin E treatment in children with IgA nephropathy significantly reduced proteinuria. While not statistically significant, there was a trend toward better preservation of glomerular filtration rate (GFR) in treated patients.
Area of Science:
- Nephrology
- Pediatrics
- Oxidative Stress Research
Background:
- IgA nephropathy is the most common primary glomerulonephropathy worldwide.
- Evidence suggests excessive oxygen-free radical production contributes to IgA nephropathy pathogenesis.
- Vitamin E, an antioxidant, has shown promise in ameliorating disease progression in animal models.
Purpose of the Study:
- To investigate the efficacy of vitamin E as an antioxidant therapy in children with biopsy-proven IgA nephropathy.
- To assess the impact of vitamin E on glomerular filtration rate (GFR), proteinuria, and hematuria.
- To evaluate the safety and tolerability of vitamin E treatment in pediatric IgA nephropathy.
Main Methods:
- A 2-year randomized, placebo-controlled study involving 55 children with IgA nephropathy.
- Vitamin E dosage was based on body weight (<30 kg: 400 IU/day; >30 kg: 800 IU/day).
- GFR, urinary protein/creatinine ratio, and urinalysis were measured at baseline, midpoint, and exit. Data analyzed using mixed-effects models.
Main Results:
- A trend towards better GFR preservation was observed in the vitamin E group (127+/-50 ml/min/1.73 m(2)) compared to placebo (112+/-31 ml/min/1.73 m(2)), though not statistically significant (P=0.09).
- The vitamin E group showed a significant reduction in proteinuria (urinary protein/creatinine ratio: 0.24+/-0.38) compared to the placebo group (0.61+/-1.37) (P<0.013).
- No significant difference in hematuria prevalence was found between the vitamin E and placebo groups.
Conclusions:
- Vitamin E treatment in children with IgA nephropathy is associated with a significant reduction in proteinuria.
- The study suggests a potential trend for improved GFR preservation with vitamin E, but further long-term studies are required.
- Antioxidant therapy with vitamin E may be a beneficial adjunct treatment for IgA nephropathy, warranting further investigation into its long-term renal function preservation effects.