Background. In numerous clinical studies that tried to identify risk factors for progressive renal function loss, the severity of proteinuria correlated with the rate of renal function loss. In ...patients with chronic renal disease and hypertension the angiotensin converting enzyme (ACE) inhibitors are the drugs of choice. ACE inhibitors have been shown to reduce proteinuria and have renoprotective effect. Angiotensin II receptor antagonists produce effects very similar to those of ACE inhibitors. Some recent clinical trials suggest that combination of ACE inhibitor with angiotensin II receptor antagonist may be more effective in reducing proteinuria than ACE inhibitor given alone.Case report. The effect of combination therapy on reducing proteinuria in a patient with Henoch-Schönlein purpura is described in this article.Conclusions. Angiotensin II receptor antagonists have the same effect on proteinuria and are as effective as ACE inhibitors. The possibility of additive effects of the two types of compounds on proteinuria has been tested yet only in small number of patients. Combination therapy may have a significant additive effect on reducing proteinuria.
Purpose We explored risk factors for lower urinary tract symptoms suggestive of benign prostatic hyperplasia in the open population. Materials and Methods A longitudinal, population based study with ...a followup of 6.5 years was done in 1,688 men who were 50 to 78 years old. Data were collected on transrectal ultrasound of prostate volume, urinary flow rate, ultrasound estimated post-void residual urine volume, generic and disease specific quality of life, and symptom severity based on the International Prostate Symptom Score. Lower urinary tract symptoms suggestive of benign prostatic hyperplasia were defined as an International Prostate Symptom Score of greater than 7 after a report of a score of less than 7 in the previous round. A multivariate Cox proportional hazard model was constructed to determine risk factors for clinical benign prostatic hyperplasia after correcting for patient age. Results Total followup was 4,353 person-years. During followup 180 events of attaining an International Prostate Symptoms Score of greater than 7 occurred. Multivariate analysis showed that functional bladder capacity, post-void residual urine volume, treatment for cardiac diseases, education level, antidepressant use, calcium antagonist use, erectile function or dysfunction, prostate specific antigen and a family history of prostate cancer were determinants with a significant HR. Conclusions In addition to age, we established 9 significant determinants for lower urinary tract symptoms suggestive of benign prostatic hyperplasia. However, not all risk factors for lower urinary tract symptoms suggestive of benign prostatic hyperplasia are accounted for since we can conclude that 1 of 3 men without these risk factors will still be diagnosed with lower urinary tract symptoms suggestive of benign prostatic hyperplasia between ages 50 and 80 years.
