Effect of losartan on proteinuria and urinary angiotensinogen excretion in non-diabetic patients with chronic kidney disease
Postgraduate Medical Journal, 10/07/2011
Lee YJ et al. – Losartan significantly decreased proteinuria and urinary angiotensinogen (UAGT) excretion, and preserved renal function in non–diabetic patients with chronic kidney disease (CKD).Methods
- Thirty–two patients with non–nephrotic–range proteinuria (0.045–0.23 g/mmol creatinine) and normal renal function between April 2005 and April 2006 were randomised to a losartan (n=17) or a control (n=15) group.
- Patients in the losartan group received losartan 50 mg/day, and the doses were titrated up to 100 mg/day after 6 weeks.
- Serum and urinary angiotensinogen concentrations were measured by sandwich ELISA.
- The primary end point was the percentage change in proteinuria.
- The secondary end points were changes in estimated glomerular filtration rate and UAGT excretion.
- The follow–up period was 24 months.
- Baseline characteristics in the two groups were similar.
- After 24 months, losartan had reduced urinary protein excretion by 43% (from mean±SD 0.13±0.04 to 0.073±0.03 g/mmol, p<0.0001), but proteinuria had not changed in the control group.
- The percentage change in mean arterial pressure did not differ between the groups.
- Losartan decreased logarithmically converted UAGT excretion (from 1.58±0.47 to 1.00±0.52, p=0.001).
- Estimated glomerular filtration rate decreased significantly only in the control group.