IgA 신증에서 spironolactone이 요중 TGF-β1 분비에 미치는 효과

Purpose : Transforming growth factor-β1 (TGF-β1) has an important role in the pathogenesis of renal damage; it enhances extracellular matrix production. Urinary TGF-β1 excretion has been shown to be significantly increased in patients with IgA nephropathy. The aim of the present study was to evaluate the effect of spironolactone on urinary TGF-β1 levels in patients with IgA nephropathy. Methods : TGF-β1 was measured by enzyme-linked immunosorbent assay in random urine specimens from 35 patients with IgA nephropathy. The patients were assigned to a spironolactone group, prednisolone group or losartan group. They were treated over an 8-week period. Urine samples were tested at the beginning and the end of the treatment period. Results : The patients with IgA nephropathy (n=35) had a higher urinary excretion of TGF-β1 than normal controls (n=13). Urinary TGF-β1 excretion was positively correlated with proteinuria and pathological grading but not with serum creatinine. After 8 weeks of treatment, losartan (n=13) and prednisolone (n=11) therapy induced a significant reduction in both urinary protein and TGF-β1 excretion. After treatment with spironolactone (n=11), urinary protein and TGF-β1 excretion were decreased. However, the decrease was not statistically significant. There was a significant correlation between the urinary TGF-β1 excretion and the serum aldosterone (r=0.84; p