Effect of add-on direct renin inhibitor aliskiren in patients with non-diabetes related chronic kidney disease
<p>Abstract</p> <p>Background</p> <p>The renin-angiotensin-aldosterone system (RAAS) plays an important role in the progression of chronic kidney disease (CKD). Although dual RAAS inhibition results in worse renal outcomes than monotherapy in high risk type 2 diabetes p...
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| Format: | Article |
| Language: | English |
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BMC
2012-08-01
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| Series: | BMC Nephrology |
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| Online Access: | http://www.biomedcentral.com/1471-2369/13/89 |
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| author | Li Szu-yuan Chen Yung-Tai Yang Wu-Chang Tarng Der-Cherng Lin Chih-Ching Yang Chih-Yu Liu Wen-Sheng |
| author_facet | Li Szu-yuan Chen Yung-Tai Yang Wu-Chang Tarng Der-Cherng Lin Chih-Ching Yang Chih-Yu Liu Wen-Sheng |
| author_sort | Li Szu-yuan |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>The renin-angiotensin-aldosterone system (RAAS) plays an important role in the progression of chronic kidney disease (CKD). Although dual RAAS inhibition results in worse renal outcomes than monotherapy in high risk type 2 diabetes patients, the effect of dual RAAS inhibition in patients with non-DM CKD is unclear. The aim of this study was to evaluate the potential renoprotective effect of add-on direct renin inhibitor in non-DM CKD patients.</p> <p>Methods</p> <p>We retrospectively enrolled 189 non-DM CKD patients who had been taking angiotensin II receptor blockers (ARBs) for more than six months. Patients were divided into an add-on aliskiren group and an ARB monotherapy group. The primary outcomes were a decline in glomerular filtration rate (GFR) and a reduction in urinary protein-to-creatinine ratio at six months.</p> <p>Results</p> <p>The baseline characteristics of the two groups were similar. Aliskiren 150 mg daily reduced the urinary protein-to-creatinine ratio by 26% (95% confidence interval, 15 to 37%; p < 0.001). The decline in GFR was smaller in the add-on aliskiren group (−2.1 vs. -4.0 ml/min, p = 0.038). Add-on aliskiren had a neutral effect on serum potassium in the non-DM CKD patients. In subgroup analysis, the proteinuria-reducing effect of aliskiren was more prominent in patients with a GFR less than 60 ml/min, and in patients with a urinary protein-to-creatinine ratio greater than 1.8. The effect of aliskiren in retarding the decline in GFR was more prominent in patients with hypertensive nephropathy than in those with glomerulonephritis.</p> <p>Conclusion</p> <p>Add-on direct renin inhibitor aliskiren (150 mg daily) safely reduced proteinuria and attenuated the decline in GFR in the non-DM CKD patients who were receiving ARBs.</p> |
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| format | Article |
| id | doaj.art-79679977244b432d83bdb1de9bb63c85 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-04-14T08:24:21Z |
| publishDate | 2012-08-01 |
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| series | BMC Nephrology |
| spelling | doaj.art-79679977244b432d83bdb1de9bb63c852022-12-22T02:04:08ZengBMCBMC Nephrology1471-23692012-08-011318910.1186/1471-2369-13-89Effect of add-on direct renin inhibitor aliskiren in patients with non-diabetes related chronic kidney diseaseLi Szu-yuanChen Yung-TaiYang Wu-ChangTarng Der-CherngLin Chih-ChingYang Chih-YuLiu Wen-Sheng<p>Abstract</p> <p>Background</p> <p>The renin-angiotensin-aldosterone system (RAAS) plays an important role in the progression of chronic kidney disease (CKD). Although dual RAAS inhibition results in worse renal outcomes than monotherapy in high risk type 2 diabetes patients, the effect of dual RAAS inhibition in patients with non-DM CKD is unclear. The aim of this study was to evaluate the potential renoprotective effect of add-on direct renin inhibitor in non-DM CKD patients.</p> <p>Methods</p> <p>We retrospectively enrolled 189 non-DM CKD patients who had been taking angiotensin II receptor blockers (ARBs) for more than six months. Patients were divided into an add-on aliskiren group and an ARB monotherapy group. The primary outcomes were a decline in glomerular filtration rate (GFR) and a reduction in urinary protein-to-creatinine ratio at six months.</p> <p>Results</p> <p>The baseline characteristics of the two groups were similar. Aliskiren 150 mg daily reduced the urinary protein-to-creatinine ratio by 26% (95% confidence interval, 15 to 37%; p < 0.001). The decline in GFR was smaller in the add-on aliskiren group (−2.1 vs. -4.0 ml/min, p = 0.038). Add-on aliskiren had a neutral effect on serum potassium in the non-DM CKD patients. In subgroup analysis, the proteinuria-reducing effect of aliskiren was more prominent in patients with a GFR less than 60 ml/min, and in patients with a urinary protein-to-creatinine ratio greater than 1.8. The effect of aliskiren in retarding the decline in GFR was more prominent in patients with hypertensive nephropathy than in those with glomerulonephritis.</p> <p>Conclusion</p> <p>Add-on direct renin inhibitor aliskiren (150 mg daily) safely reduced proteinuria and attenuated the decline in GFR in the non-DM CKD patients who were receiving ARBs.</p>http://www.biomedcentral.com/1471-2369/13/89AliskirenDirect renin inhibitorProteinuriaCKD |
| spellingShingle | Li Szu-yuan Chen Yung-Tai Yang Wu-Chang Tarng Der-Cherng Lin Chih-Ching Yang Chih-Yu Liu Wen-Sheng Effect of add-on direct renin inhibitor aliskiren in patients with non-diabetes related chronic kidney disease BMC Nephrology Aliskiren Direct renin inhibitor Proteinuria CKD |
| title | Effect of add-on direct renin inhibitor aliskiren in patients with non-diabetes related chronic kidney disease |
| title_full | Effect of add-on direct renin inhibitor aliskiren in patients with non-diabetes related chronic kidney disease |
| title_fullStr | Effect of add-on direct renin inhibitor aliskiren in patients with non-diabetes related chronic kidney disease |
| title_full_unstemmed | Effect of add-on direct renin inhibitor aliskiren in patients with non-diabetes related chronic kidney disease |
| title_short | Effect of add-on direct renin inhibitor aliskiren in patients with non-diabetes related chronic kidney disease |
| title_sort | effect of add on direct renin inhibitor aliskiren in patients with non diabetes related chronic kidney disease |
| topic | Aliskiren Direct renin inhibitor Proteinuria CKD |
| url | http://www.biomedcentral.com/1471-2369/13/89 |
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