Specific Blockage of Angiotensine 2 and Podocyturia in Glomerular Nephropathies With Hypertension and Proteinuria
Status:
Suspended
Trial end date:
1969-12-31
Target enrollment:
Participant gender:
Summary
Chronic glomerular diseases are one of the main causes leading to end stage renal disease
(ESRD). Hypertension and proteinuria are two modifiable factors promoting the progression of
ESRD. Podocyte are terminally differentiated epithelial cells and play a central role in the
progression of chronic kidney disease and in the development of glomerulosclerosis. The
presence of podocyte in urines (podocyturia) has been documented by several teams with
continuous and regular podocyturia during glomerular disease. This facts suggests that
podocyturia could become a marker of podocyte loss and glomerular damage. In our university
hospital, we developed a technique to evaluate the number of microparticles (cellular
fragments) in different biologic samples. The podocytary origin of microparticles will be
determinated thanks to specific antibodies. The aim of the present study is: i) to quantify
podocyturia during glomerular nephropathies by dosing podocyte microparticles ii) to study
the relationship between podocyturia and other biologic markers such as proteinuria iii) to
evaluate the effect of angiotensine 2 blockage on podocyturia. This is an open-labelled
randomized monocenter cross-over study. Twenty subjects with hypertension and glomerular
nephropathy characterized by proteinuria and a normal or slightly altered renal function will
be included. Patients will be treated successively by an angiotensin receptor blocker (ARB),
losartan and by a thiazide, hydrochlorothiazide, (after a wash out period). We will study the
impact of these two therapies on podocyturia. Results will be compared with others markers
like proteinuria (and its selectivity). We may finally dispose of a non invasive urinary
marker of podocyte lesions responsible for glomerulosclerosis and for ESRD progression.
Moreover mechanism of nephroprotection of the ARB may be more comprehensive.
Phase:
Phase 4
Details
Lead Sponsor:
University Hospital, Strasbourg, France
Treatments:
Angiotensin II Angiotensin Receptor Antagonists Hydrochlorothiazide Losartan