Effect of the antiplatelet drug dilazep dihydrochloride on urinary podocytes in patients in the early stage of diabetic nephropathy.

Nakamura, Tsukasa; Ushiyama, Chifuyu; Shimada, Noriaki; Sekizuka, Keiko; Ebihara, Isao; Hara, Michiaki; Koide, Hikaru

doi:10.2337/diacare.23.8.1168

Cited by 44 publications

(44 citation statements)

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“…3 There are reports suggesting that the previous use of various therapies, particularly immunosuppressants, statins and antiplatelet drugs, may interfere with the excretion of podocytes in the urine. 26,27 Most of our patients had used medications from the former two groups. Our lupus nephritis sample revealed that patients who were taking prednisone at a dosage of 5 mg/day tended to have lower podocyturia than patients who required higher doses.…”

Section: Discussionmentioning

confidence: 99%

“…Our lupus nephritis sample revealed that patients who were taking prednisone at a dosage of 5 mg/day tended to have lower podocyturia than patients who required higher doses. 25,27 In general, this low dosage is used as a maintenance treatment and reflects in our patients' renal activity control after initial treatment. On the other hand higher doses are administered in more serious and active stages of the disease.…”

Section: Discussionmentioning

confidence: 99%

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Is there a role for urinary podocyte excretion assessment in lupus nephritis?

et al. 2016

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Objective To establish the occurrence and intensity of podocyturia and its relation to grade of disease activity, as defined by clinical and laboratory criteria. Methods Prospective, cross-sectional study involving 50 patients with lupus nephritis and 29 controls, which had podocyturia levels determined from random urine samples using an immunofluorescence technique. Disease activity was graded by BILAG (renal criteria) and an additional system used in the service (S2). Results Fifty patients with lupus nephritis (WHO classes III, IV and V), with a median age of 37 years, were evaluated. Of these, 86.5% were female, and 52% were BILAG A. Podocyturia quantification in the lupus nephritis and control groups differed significantly (p ¼ 0.009). This score was higher in relation to classes III, IV and V. The correlation with C3 consumption was stronger (p ¼ 0.011) than with C4. The highest levels were found in the most active groups (A and B of BILAG and S2). Lower podocyturia correlated with a lower dose of prednisone. There was no association with the intensity of proteinuria, hematuria or pyuria, serum creatinine levels, among others. Conclusions Podocyturia assessment, which was performed by immunofluorescence in this study, can be used as an indicator of disease activity with the advantage of being a urinary biomarker. The levels proved to be higher in patients with lupus nephritis than in the controls and were particularly higher in class IV. ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Is there a role for urinary podocyte excretion assessment in lupus nephritis?

et al. 2016

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“…Several studies have also indicated that the number of PDX-positive cells in the urine falls after various therapeutic interventions in patients with FSGS, LN, HSP, IgAN, PSGN, and DN. [20][21][22][23][24][25][26] Compared with other markers, PDX proved to be the most reproducible marker for podocyte assessment in the urine of these patients. According to Vogelmann et al, 27 the cells that stained positive for PDX also stained positive for 30-40% of the other podocyte-specific markers.…”

Section: Function Of Podocytes In Kidney Diseasesmentioning

confidence: 99%

Relationship between Urinary Podocytes and Kidney Diseases

Sun

Zhao

Li³

2012

Renal Failure

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Podocyte loss is an important component of disease progression in glomerular diseases. To some extent, the loss of podocytes can predict the degree of damage and the advancement of renal disease. Detecting the loss of podocytes in the urine could be a valuable, noninvasive method for obtaining information about the activity of the disease or the disease type, allowing the early diagnosis of glomerular diseases. One of the most robust markers that has been successfully used for urinary podocyte diagnostics is podocalyxin (PDX). PDX is a sialoprotein that is expressed on podocytes and on a variety of nonrenal cells as well as on glomerular endothelial and parietal epithelial cells. Therefore, podocyte loss can be detected by the amount of PDX in the urine. The relationship between urinary podocytes and renal diseases is supported by the detection of podocytes in patients with immunoglobulin A (IgA) nephropathy, HenochSchönlein purpura nephritis, lupus nephritis, diabetic nephropathy, and focal segmental glomerulosclerosis. The use of technology for detecting podocytes in the urine would have broad implications for the evaluation of disease activity, the degree of dedifferentiation, and the possibility of regeneration.

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“…It has been reported that dilazep significantly reduces urinary protein or albumin excretion in patients with IgA nephropathy, 9) early-stage diabetic nephropathy 10,11) and normotensive autosomal dominant polycystic kidney disease. 19) Yoshida, et al 20) analyzed the relation between a reduction in proteinuria and renal histological findings in 46 patients with IgA nephropathy administered dilazep.…”

Section: Discussionmentioning

confidence: 99%

“…Among the antiplatelet agents available, dilazep hydrochloride has been reported to reduce proteinuria in IgA and diabetic nephropathies. [9][10][11] According to these reports, dilazep was approved for administration to proteinuric patients, including those with IgA nephropathy in Japan. In this study, the effects of imidapril and dilazep on proteinuria, renal function, and blood pressure in CGN patients were compared.…”

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Long-Term Effect of Imidapril Hydrochloride Compared With Dilazep Hydrochloride Administration on Blood Pressure and Renal Function in Patients With Chronic Glomerulonephritis

et al. 2005

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SUMMARYThe objective of the present study was to compare the effects of imidapril hydrochloride, an angiotensin converting enzyme inhibitor, and dilazep hydrochloride, an antiplatelet agent, on urinary protein excretion and renal function in patients with chronic glomerulonephritis.Imidapril (2.5 or 5 mg/day) or dilazep (300 or 450 mg/day) was administered for 3 years. Blood pressure, proteinuria, and renal function were measured before and during the treatment. In the group administered imidapril (n = 11), urinary protein decreased by approximately 50% (2.16 ± 1.57 versus 0.90 ± 0.53 g/g Cr, P < 0.01) and blood pressure by 14/10 mmHg (139.6 ± 17.4/93.6 ± 8.7 mmHg versus 122.7 ± 10.5/81.8 ± 9.9 mmHg, P < 0.01) and both remained at low levels during the three years of treatment. No correlation was observed between the extent of blood pressure reduction and changes in urinary protein. Serum creatinine concentrations did not change significantly (1.3 ± 0.3 versus 1.3 ± 0.3 mg/dL, NS). In the dilazep group (n = 12), there were no significant changes in blood pressure, urinary protein, or serum creatinine.These findings demonstrate that imidapril reduces proteinuria and contributes to preserve renal function, suggesting its usefulness in the treatment of patients with chronic glomerulonephritis. (Int Heart J 2005; 46: 701-710)

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Effect of the antiplatelet drug dilazep dihydrochloride on urinary podocytes in patients in the early stage of diabetic nephropathy.

Cited by 44 publications

References 13 publications

Is there a role for urinary podocyte excretion assessment in lupus nephritis?

Is there a role for urinary podocyte excretion assessment in lupus nephritis?

Relationship between Urinary Podocytes and Kidney Diseases

Long-Term Effect of Imidapril Hydrochloride Compared With Dilazep Hydrochloride Administration on Blood Pressure and Renal Function in Patients With Chronic Glomerulonephritis

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