Effect of dipyridamole with or without aspirin on urine protein excretion in patients with membranous glomerulonephritis

Abstract

The antiproteinuric effect of the antiplatelet agent dipyridamole has been assessed after inhibition of thromboxane B2 (TxB2) synthesis in 8 patients with confirmed membranous glomerulonephritis. There were three study periods, each of 30 days, and 45 days apart, namely a washout period, treatment with dipyridamole 300 mg/d, and dipyridamole 225 mg/d plus aspirin 150 mg/d. On Days 1 and 30 of each study period serum and urine creatinine, 24-h excretion of protein, creatinine clearance, platelet aggregometry on whole blood and serum TxB2 were measured. Treatment with dipyridamole alone or with aspirin produced significant inhibition of platelet aggregation and a fall in 24-h protein excretion; the latter amounted to 54% with dipyridamole alone and 56% with dipyridamole plus aspirin (NS). Dipyridamole plus aspirin caused an 82% reduction in serum TxB2.

Off the Beaten Renin–Angiotensin–Aldosterone System Pathway: New Perspectives on Antiproteinuric Therapy

“…Antiplatelet drugs have been previously used for glomerular diseases, 79 but have generally fallen out of favor, and have been replaced by more effective therapy. One exception is childhood IgA nephropathy, 80,81 particularly in Japan; a randomized trial involving 80 children with newly diagnosed IgA nephropathy found combination therapy (prednisolone, azathioprine, heparin/warfarin, and dipyridamole) to be superior to prednisolone alone.…”