Immunoglobulin A nephropathy (IgAN) is the most common glomerulonephritis worldwide. IgAN is progressive, particularly when patients have a significant proteinuria (proteinuria \>1g/g creatinine), impaired kidney function, or elevated blood pressure. In 10 years, nearly 20-40% of these IgAN patients progress to end-stage renal disease (ESRD). Early IgAN is tentatively defined when proteinuria is insignificant and kidney function and blood pressure are normal. Patients with early IgAN rarely progress to ESRD. However, 30-40% of patients with early IgAN ultimately developed a significant proteinuria and hypertension in 10 years. Therefore, earlier intervention may be needed if it can prevent the development of a significant proteinuria and hypertension. Since angiotensin ll receptor blocker (ARB) is drug of choice in reducing proteinuria and controlling blood pressure, the investigators hypothesized that early introduction of ARB may be beneficial in preventing the significant proteinuria development in early IgAN patients. To prove the hypothesis, the investigators plan the current interventional study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
174
Losartan 50 mg daily
Placebo 1 pill daily
Significant proteinuria rate
Random urine protein-to-creatinine ratio \>= 1g/g creatinine
Time frame: 144 weeks after study started
Proteinuria remission rate
Random urine protein-to-creatinine ratio \< 0.20 g/g creatinine
Time frame: 48 weeks, 96 weeks, and 144 weeks after study started
Impaired kidney function rate
estimated glomerular filtration rate decline \>= 40% from the baseline value
Time frame: 48 weeks, 96 weeks, and 144 weeks after study started
Hypertension development rate
Systolic blood pressure \>= 140 or diastolic blood pressure \>= 90
Time frame: 48 weeks, 96 weeks, and 144 weeks after study started
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