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See Latest ArticlesEffect of Telmisartan on Renal Outcomes: A Randomized Trial
Annals of Internal Medicine, 05/21/09
Mann JFE et al. - In this trial, patients with cardiovascular disease or diabetes, but without macroalbuminuria or heart failure, were randomly assigned to telmisartan or placebo. During 4 to 5 years of follow-up, telmisartan recipients had albuminuria less often but more often had doubling of serum creatinine and slight declines in estimated glomerular filtration rate than did placebo recipients. Few patients in either group required dialysis. In adults with vascular disease but without macroalbuminuria, telmisartan's effects on major renal outcomes were similar to those of placebo. These results suggest that ARBs proffer no renal benefit in ACE-intolerant people at high vascular risk but without macroalbuminuria, and are not associated with an excess of dialysis-dependent renal failure. Therefore, the effect on cardiovascular outcomes should dominate clinical decision making on whether to use telmisartan. Although telmisartan reduced proteinuria, the implications of this reduction as a surrogate marker for progression of renal disease are uncertain in patients with relatively stable estimated GFR.
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