[PP.07.04] EFFECT OF ANGIOTENSIN-CONVERTING ENZYME INHIBITORS ON PLASMINOGEN ACTIVATOR INHIBITOR – 1 LEVEL IN HYPERTENSIVE PATIENTS WITH IGA NEPHROPATHY. (September 2017)

• Record Type: Journal Article
• Authors: Xydakis, D.; Antonaki, E; Tzanakakis, M; Kostakis, K; Papadaki, A; Papadogiannakis, A
• Is Part Of: Journal of hypertension. Volume 35(2017)Supplement 2
• Publication Date: 2017-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000523362.69798.41
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: ACE inhibitors have a central role in the treatment of IgA nephropathy and especially on its evolution. IgA nephropathy is characterized by accumulation of extracellular matrix (ECM) in the kidney. PAI-1 plays a critical role in ECM remodeling in the kidney. In the present study we examined the effects of ACE inhibitors on PAI-1, a downstream mediator of angiotensin II. Design and method: 61 patients (37/24 M/F, 65.1 ± 13.4 years) with IgA nephropathy were included in our study. Patients with chronic renal failure, secondary form of hypertension, myocardial infraction, cerebrovascular disease and other form of nephropathy were excluded. All antihypertensive medications were discontinued for 2 weeks. At the end of this period, in all patients were measured albumin excretion rate (AER), plasma renin activity, aldosterone, plasma level of PAI-1, fibrinogen (base line measurement), IL-6, CRP. Patients were then treated with perindopril 5 mg/day in a single dose. Plasma levels of renin, aldosterone, PAI-1, fibrinogen, IL-6, CRP were measured again at a 4 and 8 weeks period. Results: The effect on blood pressure (systolic, diastolic) of perindopril was of statistical significance. Base line levels of PAI-1 were 53.3 ± 12.3 ng/ml. PAI-1 levels at the 4th week were decreased significantly (29.9 ± 5.4 ng/ml post treatment vs 53.3 ± 12.3 ng/ml pre treatment, p < 0.05). At the 8th week, levels of PAI-1 were reduced, but not significantly in comparison with the end of the 4th week (27.7 ± 6.9 ng/ml vs 29.9 ± 5.4 ng/ml, p > 0.05) Conclusions: Our data suggest that ACE inhibitors decrease plasma levels of PAI-1 in patients with IgA nephropathy, especially during the first four weeks of treatment. These drugs may influence the progression of IgA nephropathy by reducing renal matrix expansion, a process that central role has PAI-1.