Document Detail

Angiotensin II antagonism improves the lipoprotein profile in patients with nephrotic syndrome.
MedLine Citation:
PMID:  18800457     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To study the effects of the angiotensin II receptor antagonist losartan on the lipid profile of patients with nephrotic range proteinuria. DESIGN: A single-blind, longitudinal study. Patients were followed during four periods each lasting 1 month, in which they received in sequence once-daily placebo, 50 mg losartan, 100 mg losartan and placebo, respectively. Measurements were performed at the end of each study period. PATIENTS: Eleven patients with biopsy-proven renal disease, diastolic blood pressure > or = 90 mmHg, creatinine clearance > or = 50 ml/min, stable proteinuria > or = 2.5 g/day, without familial hyperlipidemia or use of hypolipidemic agents. RESULTS: At the end of the 100 mg losartan period, median arterial blood pressure had fallen from 114.5 +/- 2.3 mmHg at baseline to 96 +/- 2.8 mmHg (P < 0.001). Urinary protein excretion decreased from 6.2 +/- 1.3 g/day to 4.2 +/- 1.3 g/day (P < 0.001), whereas serum albumin and total protein did not change. Total cholesterol fell significantly from 6.67 +/- 0.46 mmol/l to 6.08 +/- 0.42 mmol/l (P = 0.04). This decrease in cholesterol was mainly due to a decrease in very-low-density and low-density lipoprotein cholesterol, though high-density lipoprotein cholesterol also tended to fall. Apolipoprotein B decreased by 13.0 +/- 3.6% (P = 0.05), whereas the apolipoprotein A1 concentration remained unchanged, thus resulting in a significant increase in the apolipoprotein A1/B ratio (12.5 +/- 3.5%, P = 0.05). Lipoprotein(a) concentration fell from 287 +/- 57 mg/l to 218 +/- 35 mg/l (P = 0.07). Interestingly, those patients that had the highest baseline lipoprotein(a) values showed the most outspoken change in lipoprotein(a) levels during treatment. In the placebo recovery period all parameters returned towards baseline values. CONCLUSIONS: In addition to lowering blood pressure and proteinuria, the angiotensin II antagonist losartan improves the lipoprotein profile in patients with nephrotic range proteinuria.
D de Zeeuw; R T Gansevoort; R P Dullaart; P E de Jong
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of hypertension. Supplement : official journal of the International Society of Hypertension     Volume:  13     ISSN:  0952-1178     ISO Abbreviation:  J Hypertens Suppl     Publication Date:  1995 Jul 
Date Detail:
Created Date:  2008-09-19     Completed Date:  2008-10-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501422     Medline TA:  J Hypertens Suppl     Country:  England    
Other Details:
Languages:  eng     Pagination:  S53-8     Citation Subset:  IM    
Department of Medicine, State University Hospital, Groningen, The Netherlands.
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MeSH Terms
Angiotensin II / antagonists & inhibitors*
Angiotensin II Type 1 Receptor Blockers / pharmacology,  therapeutic use*
Apolipoprotein A-I / blood
Apolipoproteins B / blood
Blood Pressure / drug effects
Cholesterol / blood
Cholesterol, HDL / blood
Cholesterol, LDL / blood
Cholesterol, VLDL / blood
Lipoproteins / blood*
Longitudinal Studies
Losartan / pharmacology,  therapeutic use*
Middle Aged
Nephrotic Syndrome / blood*,  drug therapy*
Proteinuria / blood,  drug therapy
Single-Blind Method
Triglycerides / blood
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Apolipoprotein A-I; 0/Apolipoproteins B; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Cholesterol, VLDL; 0/Lipoproteins; 0/Triglycerides; 11128-99-7/Angiotensin II; 114798-26-4/Losartan; 57-88-5/Cholesterol

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