Document Detail


Long-term antiproteinuric effect of dual renin-angiotensin system blockade.
MedLine Citation:
PMID:  19426247     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We evaluated the long-term changes on overt proteinuria induced by dual blockade of the renin-angiotensin system (RAS). Dual blockade was produced by adding an angiotensin II receptor blocker (ARB) to treatment with maximal recommended doses of an angiotensin converting enzyme (ACE) inhibitor in proteinuric patients. A total of 28 patients (19 men and 9 women) with proteinuria higher than 1 g/24 h were enrolled in this trial of treatment with the ARB candesartan (from 4 up to 32 mg daily) added to existing treatment with an ACE inhibitor. At 6, 12, 24, and 36 months, we evaluated proteinuria in 24-h urinary collections, office blood pressure (BP), plasmatic creatinine (Cr), serum potassium (K), and 24 h urine collection creatinine clearance (CrC). During monoblockade of the RAS by ACE inhibitor treatment, albuminuria was 2.94 +/- 1.92 mg/24 h; BP was 137/76 mmHg; K+ was 4.8 +/- 0.5 mmol/l, Cr was 1.76 +/- 0.67 mg/dL, and CrC was 62 +/- 31.9 mL/min. After 6 months, dual blockade of the RAS albuminuria was 2.18 +/- 2.29 mg/24 h (P < 0.01 vs. baseline) and BP was 133/75 mmHg (not significant). At 36 months, albuminuria was 2.21 +/- 2.20 mg/24 h (P < 0.05 vs. baseline); BP was 133/73 mmHg (not significant). CrC was not changed along the follow up. A small increment of Cr was detected at 24 months (2.11 +/- 1.06 mg/mL, P < 0.05). The antiproteinuric effect of dual renin-angiotensin system blockade combining candesartan and ACE inhibitors remain after 36 months without losing its initial effect. Blood pressure changes seem not to explain this long-term antiproteinuric effect.
Authors:
N R Robles; E Fernandez Carbonero; B Romero; E Sánchez Casado; J J Cubero
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Cardiovascular therapeutics     Volume:  27     ISSN:  1755-5914     ISO Abbreviation:  Cardiovasc Ther     Publication Date:  2009  
Date Detail:
Created Date:  2009-05-11     Completed Date:  2009-07-09     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  101319630     Medline TA:  Cardiovasc Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  101-7     Citation Subset:  IM    
Affiliation:
Servicio de Nefrología, Hospital Infanta Cristina, Badajoz, Spain. nroblesp@senefro.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiotensin II Type 1 Receptor Blockers / therapeutic use*
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Benzimidazoles / therapeutic use*
Blood Pressure / drug effects
Creatinine / blood,  urine
Drug Therapy, Combination
Female
Humans
Male
Middle Aged
Potassium / blood
Proteinuria / drug therapy*,  metabolism,  physiopathology
Tetrazoles / therapeutic use*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Benzimidazoles; 0/Tetrazoles; 60-27-5/Creatinine; 7440-09-7/Potassium; S8Q36MD2XX/candesartan

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


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