Aliskiren add-on therapy effectively reduces proteinuria in chronic kidney disease: An open-label prospective trial
Introduction: The combination therapy of aliskiren and renin–angiotensin–aldosterone system (RAAS) blocker in chronic kidney disease (CKD) is controversial. Whether such dual blockade can effectively apply to patients with CKD irrespective of stage and amount of proteinuria remains uncertain. Method...
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| Format: | Article |
| Language: | English |
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SAGE Publications
2014-09-01
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| Series: | Journal of the Renin-Angiotensin-Aldosterone System |
| Online Access: | https://doi.org/10.1177/1470320312467560 |
| _version_ | 1797283600545087488 |
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| author | Men-Tai Wu Shi-Cheng Tung Kao-Tai Hsu Chien-Te Lee |
| author_facet | Men-Tai Wu Shi-Cheng Tung Kao-Tai Hsu Chien-Te Lee |
| author_sort | Men-Tai Wu |
| collection | DOAJ |
| description | Introduction: The combination therapy of aliskiren and renin–angiotensin–aldosterone system (RAAS) blocker in chronic kidney disease (CKD) is controversial. Whether such dual blockade can effectively apply to patients with CKD irrespective of stage and amount of proteinuria remains uncertain. Methods: We added aliskiren at a dosage of 150 mg/day for six months in 103 Chinese CKD patients who had been treated with angiotensin converting enzyme inhibitors (ACEis) or angiotensin receptor blockers (ARBs) and still had significant proteinuria or uncontrolled hypertension. Blood pressure, serum creatinine, estimated glomerular filtration rate (eGFR), potassium, and spot urine protein-to-creatinine ratio (UPCR) were measured at three and six months after aliskiren add-on therapy and compared with baseline. Results: The combination of aliskiren and ACEi or ARB significantly reduced UPCR by 23% ( p =0.001) and mean arterial pressure by 7.9 ± 13.8 mmHg ( p <0.001) at six months. Twenty-five percent of subjects had a greater than 50% reduction in UPCR. No significant changes in eGFR and serum potassium level were noted at six months. Conclusions: Adding aliskiren on ACEi or ARB in CKD patients, both in diabetes and non-diabetes, has a favorable effect on reducing residual proteinuria and inadequately controlled blood pressure. |
| first_indexed | 2024-03-07T17:34:07Z |
| format | Article |
| id | doaj.art-680fec1e8f394d9388720752d0240d02 |
| institution | Directory Open Access Journal |
| issn | 1470-3203 1752-8976 |
| language | English |
| last_indexed | 2024-03-07T17:34:07Z |
| publishDate | 2014-09-01 |
| publisher | SAGE Publications |
| record_format | Article |
| series | Journal of the Renin-Angiotensin-Aldosterone System |
| spelling | doaj.art-680fec1e8f394d9388720752d0240d022024-03-02T17:16:09ZengSAGE PublicationsJournal of the Renin-Angiotensin-Aldosterone System1470-32031752-89762014-09-011510.1177/1470320312467560Aliskiren add-on therapy effectively reduces proteinuria in chronic kidney disease: An open-label prospective trialMen-Tai Wu0Shi-Cheng Tung1Kao-Tai Hsu2Chien-Te Lee3Division of Nephrology, Endocrinology/Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, TaiwanEndocrinology/Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, TaiwanDivision of Nephrology, Endocrinology/Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, TaiwanDivision of Nephrology, Endocrinology/Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, TaiwanIntroduction: The combination therapy of aliskiren and renin–angiotensin–aldosterone system (RAAS) blocker in chronic kidney disease (CKD) is controversial. Whether such dual blockade can effectively apply to patients with CKD irrespective of stage and amount of proteinuria remains uncertain. Methods: We added aliskiren at a dosage of 150 mg/day for six months in 103 Chinese CKD patients who had been treated with angiotensin converting enzyme inhibitors (ACEis) or angiotensin receptor blockers (ARBs) and still had significant proteinuria or uncontrolled hypertension. Blood pressure, serum creatinine, estimated glomerular filtration rate (eGFR), potassium, and spot urine protein-to-creatinine ratio (UPCR) were measured at three and six months after aliskiren add-on therapy and compared with baseline. Results: The combination of aliskiren and ACEi or ARB significantly reduced UPCR by 23% ( p =0.001) and mean arterial pressure by 7.9 ± 13.8 mmHg ( p <0.001) at six months. Twenty-five percent of subjects had a greater than 50% reduction in UPCR. No significant changes in eGFR and serum potassium level were noted at six months. Conclusions: Adding aliskiren on ACEi or ARB in CKD patients, both in diabetes and non-diabetes, has a favorable effect on reducing residual proteinuria and inadequately controlled blood pressure.https://doi.org/10.1177/1470320312467560 |
| spellingShingle | Men-Tai Wu Shi-Cheng Tung Kao-Tai Hsu Chien-Te Lee Aliskiren add-on therapy effectively reduces proteinuria in chronic kidney disease: An open-label prospective trial Journal of the Renin-Angiotensin-Aldosterone System |
| title | Aliskiren add-on therapy effectively reduces proteinuria in chronic kidney disease: An open-label prospective trial |
| title_full | Aliskiren add-on therapy effectively reduces proteinuria in chronic kidney disease: An open-label prospective trial |
| title_fullStr | Aliskiren add-on therapy effectively reduces proteinuria in chronic kidney disease: An open-label prospective trial |
| title_full_unstemmed | Aliskiren add-on therapy effectively reduces proteinuria in chronic kidney disease: An open-label prospective trial |
| title_short | Aliskiren add-on therapy effectively reduces proteinuria in chronic kidney disease: An open-label prospective trial |
| title_sort | aliskiren add on therapy effectively reduces proteinuria in chronic kidney disease an open label prospective trial |
| url | https://doi.org/10.1177/1470320312467560 |
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