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Renoprotective effect of the addition of losartan to ongoing treatment with an angiotensin converting enzyme inhibitor in type-2 diabetic patients with nephropathy.
Hypertens Res. 2007 Oct; 30(10):929-35.HR

Abstract

Angiotensin converting enzyme inhibitors (ACE-Is) and angiotensin II receptor blockers (ARBs) are frequently used for the treatment for glomerulonephritis and diabetic nephropathy because of their albuminuria- or proteinuria-reducing effects. To many patients who are nonresponsive to monotherapy with these agents, combination therapy appears to be a good treatment option. In the present study, we examined the effects of the addition of an ARB (losartan) followed by titration upon addition and at 3 and 6 months (n=14) and the addition of an ACE-I followed by titration upon addition and at 3 and 6 months (n=20) to the drug regimen treatment protocol in type 2 diabetic patients with nephropathy for whom more than 3-month administration of an ACE-I or the combination of an ACE-I plus a conventional antihypertensive was ineffective to achieve a blood pressure (BP) of 130/80 mmHg and to reduce urinary albumin to <30 mg/day. During the 12-month treatment, addition of losartan or addition of an ACE-I to the treatment protocol reduced systolic blood pressure (SBP) by 10% and 12%, diastolic blood pressure (DBP) by 7% and 4%, and urinary albumin excretion by 38% and 20% of the baseline value, respectively. However, the effects on both BP and urinary albumin were not significantly different between the two therapies. In conclusion, addition of losartan or an ACE-I to an ongoing treatment with an ACE-I, or addition of an ACE-I to ongoing treatment with a conventional antihypertensive were equally effective at reducing the urinary albumin excretion and BP, and provided renal protection in patients with type-2 diabetic nephropathy.

Authors+Show Affiliations

Second Department of Internal Medicine, Gifu University School of Medicine, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

18049024

Citation

Abe, Hirohiko, et al. "Renoprotective Effect of the Addition of Losartan to Ongoing Treatment With an Angiotensin Converting Enzyme Inhibitor in Type-2 Diabetic Patients With Nephropathy." Hypertension Research : Official Journal of the Japanese Society of Hypertension, vol. 30, no. 10, 2007, pp. 929-35.
Abe H, Minatoguchi S, Ohashi H, et al. Renoprotective effect of the addition of losartan to ongoing treatment with an angiotensin converting enzyme inhibitor in type-2 diabetic patients with nephropathy. Hypertens Res. 2007;30(10):929-35.
Abe, H., Minatoguchi, S., Ohashi, H., Murata, I., Minagawa, T., Okuma, T., Yokoyama, H., Takatsu, H., Takaya, T., Nagano, T., Osumi, Y., Kakami, M., Tsukamoto, T., Tanaka, T., Hiei, K., & Fujiwara, H. (2007). Renoprotective effect of the addition of losartan to ongoing treatment with an angiotensin converting enzyme inhibitor in type-2 diabetic patients with nephropathy. Hypertension Research : Official Journal of the Japanese Society of Hypertension, 30(10), 929-35.
Abe H, et al. Renoprotective Effect of the Addition of Losartan to Ongoing Treatment With an Angiotensin Converting Enzyme Inhibitor in Type-2 Diabetic Patients With Nephropathy. Hypertens Res. 2007;30(10):929-35. PubMed PMID: 18049024.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Renoprotective effect of the addition of losartan to ongoing treatment with an angiotensin converting enzyme inhibitor in type-2 diabetic patients with nephropathy. AU - Abe,Hirohiko, AU - Minatoguchi,Shinya, AU - Ohashi,Hiroshige, AU - Murata,Ichijiro, AU - Minagawa,Taro, AU - Okuma,Toshio, AU - Yokoyama,Hitomi, AU - Takatsu,Hisato, AU - Takaya,Tadatake, AU - Nagano,Toshihiko, AU - Osumi,Yukio, AU - Kakami,Masao, AU - Tsukamoto,Tatsuo, AU - Tanaka,Tsutomu, AU - Hiei,Kunihiko, AU - Fujiwara,Hisayoshi, PY - 2007/12/1/pubmed PY - 2008/4/9/medline PY - 2007/12/1/entrez SP - 929 EP - 35 JF - Hypertension research : official journal of the Japanese Society of Hypertension JO - Hypertens Res VL - 30 IS - 10 N2 - Angiotensin converting enzyme inhibitors (ACE-Is) and angiotensin II receptor blockers (ARBs) are frequently used for the treatment for glomerulonephritis and diabetic nephropathy because of their albuminuria- or proteinuria-reducing effects. To many patients who are nonresponsive to monotherapy with these agents, combination therapy appears to be a good treatment option. In the present study, we examined the effects of the addition of an ARB (losartan) followed by titration upon addition and at 3 and 6 months (n=14) and the addition of an ACE-I followed by titration upon addition and at 3 and 6 months (n=20) to the drug regimen treatment protocol in type 2 diabetic patients with nephropathy for whom more than 3-month administration of an ACE-I or the combination of an ACE-I plus a conventional antihypertensive was ineffective to achieve a blood pressure (BP) of 130/80 mmHg and to reduce urinary albumin to <30 mg/day. During the 12-month treatment, addition of losartan or addition of an ACE-I to the treatment protocol reduced systolic blood pressure (SBP) by 10% and 12%, diastolic blood pressure (DBP) by 7% and 4%, and urinary albumin excretion by 38% and 20% of the baseline value, respectively. However, the effects on both BP and urinary albumin were not significantly different between the two therapies. In conclusion, addition of losartan or an ACE-I to an ongoing treatment with an ACE-I, or addition of an ACE-I to ongoing treatment with a conventional antihypertensive were equally effective at reducing the urinary albumin excretion and BP, and provided renal protection in patients with type-2 diabetic nephropathy. SN - 0916-9636 UR - https://www.unboundmedicine.com/medline/citation/18049024/Renoprotective_effect_of_the_addition_of_losartan_to_ongoing_treatment_with_an_angiotensin_converting_enzyme_inhibitor_in_type_2_diabetic_patients_with_nephropathy_ L2 - https://medlineplus.gov/diabetickidneyproblems.html DB - PRIME DP - Unbound Medicine ER -