EFFECT OF ASPIRIN AND DIPYRIDAMOLE ON PROTEINURIA IN IDIOPATHIC MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS - A MULTICENTER PROSPECTIVE CLINICAL-TRIAL

Idiopathic membranoproliferative glomerulonephritis (MPGN) has a poor prognosis, with 90% of patients requiring dialysis treatment after 20 years regardless of therapy. Up to 34% of patients may die due to thro mbotic complications or sepsis. This study investigates the influence of aspirin plus dipyridamole on proteinuria and renal function in neph rotic MPGN patients with moderately reduced glomerular filtration rate . Eighteen patients with biopsy-proven MPGN (15 type 1, 3 type II) and nephrotic syndrome were randomly assigned to receive protein restrict ion, anti-hypertensive therapy (control group) or in addition aspirin and dipyridamole (treatment group). Patients were prospectivly followe d for a mean of 36 months. Serum creatinine remained unchanged after 3 6 months compared to baseline in both groups. In the treatment group p roteinuria was reduced from 8.3 +/- 1.4 to 1.6 +/- 0.7 g/day (P < 0.05 ). In control patients proteinuria decreased from 7.1 +/- 1.6 to 4.3 /- 1.1 g/day. After 36 months proteinuria was significantly lower in t he treatment group compared to control (P < 0.02 Mann-Whitney rank sum test). In conclusion, aspirin plus dipyridamole may be of value in re versing nephrotic syndrome and associated risks in patients with MPGN and moderately reduced renal function.