Document Detail

Autoregulated glomerular filtration rate during candesartan treatment in hypertensive type 2 diabetic patients.
MedLine Citation:
PMID:  11576357     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Impaired autoregulation of the glomerular filtration rate (GFR) implies disturbances in the downstream transmission of the systemic blood pressure into the glomerulus, leading to capillary hypertension or hypotension dependent of the level of blood pressure. The impact on renal autoregulation of different antihypertensive drugs in animals has been elucidated, whereas information in humans is lacking.
METHODS: A randomized, double-blind crossover study with candesartan cilexetil 16 mg o.d. and placebo was performed in 17 hypertensive type 2 diabetic patients without nephropathy. Each treatment arm lasted four weeks. On the last day, GFR (single shot [51Cr] EDTA plasma clearance technique for 4 hours) was measured twice between 8 a.m. and 5 p.m., first without clonidine and then after an intravenous injection of clonidine 75 microg. Blood pressure (Takeda TM2420, A&D, Tokyo, Japan) was measured every ten minutes, and the urinary albumin excretion rate (UAER) was measured by ELISA during each GFR determination.
RESULTS: Candesartan induced a mean (SE) reduction in mean arterial blood pressure (MABP) of 6 (2) mm Hg (P < 0.02) and had a tendency to reduce UAER (P = 0.07), while GFR remained unchanged (95 vs. 93 mL/min/1.73 m2). Clonidine reduced MABP with 17 (2) versus 16 (1) mm Hg during placebo versus candesartan 16 mg o.d., respectively (NS). GFR diminished in average from 95 (3) to 92 (4) mL/min/1.73 m2 with placebo (NS), and from 93 (3) to 89 (4) mL/min/1.73 m2 during treatment with candesartan (NS). The mean difference (95% CI) in the changes in GFR between the examination with placebo and with candesartan was 0.1 (-5.5 to 5.8) mL/min/1.73 m2 (NS).
CONCLUSION: Candesartan reduces blood pressure without adversely altering the preserved ability to autoregulate GFR in hypertensive type 2 diabetic patients without nephropathy.
P K Christensen; S Lund; H H Parving
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Kidney international     Volume:  60     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-09-28     Completed Date:  2002-01-03     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1435-42     Citation Subset:  IM    
Steno Diabetes Center, Gentofte, Denmark.
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MeSH Terms
Angiotensin Receptor Antagonists
Antihypertensive Agents / therapeutic use*
Benzimidazoles / therapeutic use*
Biphenyl Compounds / therapeutic use*
Blood Pressure / drug effects
Clonidine / therapeutic use
Cross-Over Studies
Diabetes Mellitus, Type 2*
Diabetic Angiopathies / drug therapy*,  physiopathology
Double-Blind Method
Glomerular Filtration Rate / drug effects*
Homeostasis / drug effects*
Hypertension / drug therapy*,  physiopathology
Middle Aged
Reg. No./Substance:
0/Angiotensin Receptor Antagonists; 0/Antihypertensive Agents; 0/Benzimidazoles; 0/Biphenyl Compounds; 0/Tetrazoles; 4205-90-7/Clonidine; R85M2X0D68/candesartan cilexetil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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