VEGF signaling pathway inhibitors associated proteinuria
Conditions
Interventions
control group:Supportive therapy was given to observe changes in urinary protein
if new hypertension or existing hypertension was aggravated during the study, other types of antihypertensive drugs including CCB, ßblocker, ablocker or diuretic except renin vascular-angiotensin syst
New addition of SGLT-2 inhibitors, mineralocorticoid receptor antagonists were avoided during the study.
test group:Supportive therapy was given, with losartan potassium (50mg days, or 100mg / day), gradually titrated to the maximum tolerated dose (50mg / day, or 100mg / day) and remained stable. The pat
Sponsors
Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: 1. Voluntary signed informed consent form 2. Age: 18-75 years, no gender limit 3 Patients with a previously diagnosed malignancy 4 Patients being treated with VSPIs 5. One visit during the screening period: For patients with negative conventional albuminuria before VSPIs, 1 + was further followed by: a)0.3g <24 h urinary protein quantification (24HUTP)<1.5g; or b)0.3g/g <urinary protein to creatinine ratio (UPCR)<1.5g/g; a) and b) Prominuria was mainly albumin and globulin; or c) 300mg / g=urinary albumin to creatinine ratio (UACR)=1000mg / g For patients with positive conventional proteinuria before VSPIs, 1) conventional proteinuria increased from 1 + to 2 + or above; or 2) 24 HUTP or UPCR or UACR increased 25% from before treatment; 1) or 2) a) b) c) any of 3 6. Glomerular filtration rate [eGFR (CKD-EPI 2009)]=30ml/min/1.73m2
Exclusion criteria
Exclusion criteria: 1.Routine urine protein 2 + before using VSPIs; 2. Patients with acute kidney injury (AKI); 3. Other possible causes of proteinuria include systemic vasculitis, anti-GBM glomerulonephritis, monoclonal gammaglobulinemia of renal significance, IgG 4-associated nephritis, lupus nephritis, and other associated glomerular diseases (e. g., diabetic nephropathy). If proteinuria caused by other reasons cannot be excluded clinically, it should be clarified by kidney biopsy; 4. Patients who experienced any of the following cardiovascular events within 24 weeks: myocardial infarction, unstable angina, ventricular arrhythmia, New York Heart Association Grade II heart failure, stroke, etc.; 5. Patients with renal artery stenosis; 6. Patients with hyperkalemia (blood potassium greater than 5.3 mmol/l); 7. Patients with low blood pressure (SBP 25 mmol/l); 12. Women born during pregnancy or lactation; 13. Subjects judged by the investigator for the study; 14. Patients with an estimated survival period of less than 1 year as judged by the investigator; 15. Allergy or known allergy or intolerance to any component of losartan potassium;16. Patients currently taking SGLT-2 inhibitors; 17. Patients taking mineralocorticoid receptor antagonists.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| urine albumin-creatinine ratio; | — |
Secondary
| Measure | Time frame |
|---|---|
| urine protein to creatinine ratio;quantification of the 24-h urinary protein;estimated glomerular filtration rate; | — |
Countries
China
Contacts
Public ContactMiaolin Che
Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Outcome results
None listed