A Comparison of the Antihypertensive and Anti-Inflammatory Effects of Aliskiren and Ramipril Add-On Therapy in Peritoneal Dialysis Patients – A Pilot Open Label Study
Kidney and Blood Pressure Research, 07/05/2012
Clinical Article
Makówka A et al. - Aliskiren 150 mg/day decreases blood pressure less effectively than ramipril 5 mg/day in peritoneal dialysis patients. It does not influence serum potassium. The decrease of monocyte chemotactic protein-1 (MCP-1) concentration after aliskiren treatment may provide an indirect evidence for its blood pressure independent cardioprotective and anti-inflammatory effects.
Methods- Eighteen hypertensive patients on chronic peritoneal dialysis were enrolled in an open-label comparative fixed-order study.
- The patients had been off RAAS blocking drugs for ≥4 weeks prior to an inclusion.
- At each of 3 study visits (baseline and after each of the treatment periods) blood pressure, serum lipids, potassium, renin, aldosterone, C-reactive protein (CRP) and monocyte chemotactic protein-1 (MCP-1) were measured.
- After the baseline visit aliskiren was started (150 mg/d) and after 12 weeks replaced with ramipril (5 mg/d) for the next 12 weeks.
- Blood pressure was 142/88±15/11 mmHg at baseline, 137/84±10/8 mmHg after aliskiren (ns) and 126/81±11/7 mmHg after ramipril (p<0.05 vs baseline and aliskiren).
- No incidents of hyperkalemia were observed.
- Plasma renin concentration increased significantly during aliskiren treatment compared to ramipril (227,6±844 vs 58,3±765 pg/mL).
- CRP was similar after both therapies (8,8±34 vs 8,4±32 µg/mL) but MCP-1 concentration was significantly lower after aliskiren than after ramipril (294,0±172,6 vs 358,9±183,3 pg/mL).
