BACKGROUND: Proteinuria is an independent risk factor for grafted renal function after renal transplantation. Both Tripterygium wilforilii Hook. f. (TII) and losartan can reduce urine protein excretion.
OBJECTIVE: To observe effect of combined regime of TII plus losartan or amlodipine on proteinuria after renal transplantation.
METHODS: Forty patients with proteinuria and mild or moderate hypertension after renal transplantation were selected during the follow-up in Foshan First People’s Hospital. The patients were divided into two groups according to random number table. The patients in the TII+losartan group took 0.5 mg/(kg•d) TII and 50 mg/d losartan; the patients in the TII+amlodipine group took 0.5 mg/(kg•d) TII and 50 mg/d amlodipine. The blood pressure was controlled under 130/80 mm Hg (1 mm Hg=0.133 kPa). After 6 months, the blood pressure, liver and renal function, blood and urine routine, drug concentration, urine protein of 24 hours and side effects of these drugs were tested.
RESULTS AND CONCLUSION: The final analysis showed that the systolic pressure and diastolic pressure were remarkably decreased (P < 0.05); and after 6 months, the systolic pressure and diastolic pressure reached the aim values (P < 0.01). There was no obvious difference between these two groups in blood drop-out value, mean arterial pressure and the total effective rate (P > 0.05). There was no obvious difference of blood urea nitrogen, creatinine, and serum uric acid before and after treatment   (P > 0.05). The urine protein was notably reduced in both groups after treatment, but there was no significant difference between two groups (P > 0.05). The dosage of cyclosporine was significantly reduced (P < 0.05). For the patients with proteinuria and mild or moderate hypertension after renal transplantation, the combined regime of TII plus losartan or amlodipine could release the blood pressure smoothly, reduce the proteinuria, descend the dosage of cyclosporine and meanwhile protect the renal functions.