Effect of angiotensin receptor blockers on blood pressure and renal function in patients with concomitant hypertension and chronic kidney disease: a systematic review and meta-analysis

Burnier, Michel; Lin, Song; Ruilope, Luis; Bader, Giovanni; Durg, Sharanbasappa; Brunel, Patrick

doi:10.1080/08037051.2019.1644155

Cited by 18 publications

(16 citation statements)

References 91 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The lack of differences in food intake, urine output and creatinine clearance between control and losartan-treated rats observed in the current study are also in line with results of previous studies [17][18][19][20][21][22]. Interestingly, we did not observe any differences in serum concentrations and urinary excretions of the electrolytes, albumin and protein between controls and losartan-treated rats (Tables 2 and 3), in both groups.…”

Section: Discussionsupporting

confidence: 93%

Changes in the Urinary Metabolites in Losartan-Treated Spontaneously Hypertensive Rats

Azis¹,

Kamal²,

Radjeni³

et al. 2021

JCHS

View full text Add to dashboard Cite

Introduction: This study examined the association of losartan induced changes in urinary metabolomic profile with the changes in blood pressure (BP) and renin-angiotensin- aldosterone system (RAAS) in spontaneously hypertensive rats (SHR). Methods: Male SHR were administered with either 0.5 mL of distilled water (control group, n=6) or 10 mg.kg -1 of losartan (group 2, n=6) daily by oral gavage for 4 weeks. Body weight, BP, food and water intake were measured weekly. At week 4, urine was collected for urinary electrolyte analysis and metabolite profiling, after which the animals were euthanised by decapitation and blood was collected for analysis of components of RAAS and electrolyte concentrations. Urine metabolite profile of SHR was determined using proton nuclear magnetic resonance ( 1 H-NMR) spectrometry combined with multivariate data analysis. Results: At week 4, losartan- treated SHR had significantly lower BP than non-treated SHR. There were no differences in water and food intake, body weight, serum and urinary electrolyte concentrations or in their urinary excretions between the two groups. No differences were evident in the components of RAAS except that the angiotensinogen level was significantly higher in losartan-treated SHR compared to non-treated SHR. Orthogonal partial least squares discriminant analysis (OPLS-DA) showed clear separation of urinary metabolites between control and losartan-treated SHR. Losartan-treated SHR group was separated from the control group by changes in the intermediates involved in glycine, serine and threonine metabolism. Conclusion: Antihypertensive effect of losartan in SHR seems to be associated with changes in urinary metabolite profile, particularly involving the metabolism of glycine, serine and threonine.

show abstract

Section: Discussionsupporting

confidence: 93%

Changes in the Urinary Metabolites in Losartan-Treated Spontaneously Hypertensive Rats

Azis¹,

Kamal²,

Radjeni³

et al. 2021

JCHS

View full text Add to dashboard Cite

show abstract

“…carried out a meta‐analysis on how angiotensin receptor blockers affect the renal function and BP in hypertension patients with CKD. The authors found that after ≥1 year angiotensin receptor blocker monotherapy, proteinuria and hypertension were significantly alleviated (Δproteinuria = −0.90 [95% CI −1.22 to −0.59] g/L, ΔSBP = −14.84 [95% CI −17.82 to −11.85] and ΔDBP = −10.27 [95% CI −12.26 to −8.27] mmHg, P < 0.01), but there were no significant changes in the eGFR 31 . These results were consistent with those of combination therapy.…”

Section: Discussionmentioning

confidence: 99%

Sodium–glucose cotransporter 2 inhibitor‐induced reduction in the mean arterial pressure improved renal composite outcomes in type 2 diabetes mellitus patients with chronic kidney disease: A propensity score‐matched model analysis in Japan

Kobayashi

Toyoda

Hatori

et al. 2021

J of Diabetes Invest

View full text Add to dashboard Cite

Aims/Introduction Large‐scale clinical trials have reported that, in patients with type 2 diabetes mellitus, sodium–glucose cotransporter 2 (SGLT2) inhibitor treatment affords favorable renal outcomes; the underlying mechanisms, however, remain unclear. Thus, this study investigated how SGLT2 inhibitor‐induced changes in the mean arterial pressure (MAP; denoted as ΔMAP) are associated with renal outcomes in type 2 diabetes mellitus patients with chronic kidney disease (CKD). Materials and Methods We retrospectively assessed the data of 624 Japanese type 2 diabetes mellitus patients with CKD who had been using SGLT2 inhibitors for >1 year. For propensity score matching (1:1 nearest neighbor match, with caliper value = 0.053, no replacement), patients were categorized into two groups based on the ΔMAP (>−4 mmHg [n = 329] and ≤−4.0 mmHg [n = 295]). Composite albuminuria progression or a ≥15% annual reduction in the estimated glomerular filtration rate was regarded as the end‐point. Results Per group, 173 propensity‐matched patients were compared. Patients with ΔMAP ≤−4 mmHg had a significantly lower incidence of composite renal outcomes than those with ΔMAP ≥−4 mmHg (5.8% [n = 10] vs 15.6% [n = 27], P = 0.003). Although the between‐group differences in the estimated glomerular filtration rates were non‐significant, patients with a ΔMAP ≤−4 mmHg had significantly larger reductions in the logarithmic urine albumin‐to‐creatinine ratio (P = 0.005). Conclusions The degree of blood pressure reduction after SGLT2 inhibitor treatment influenced renal composite outcomes in Japanese type 2 diabetes mellitus patients with CKD, confirming the importance of blood pressure management in type 2 diabetes mellitus patients with CKD, even when they are under SGLT2 inhibitor treatment.

show abstract

“…biphenyl carboxylic acid with the empirical formula C33H30N4O2. 24 Telmisartan was the most lipophilic with a log p-value (partition coefficient) of 6.66; followed by Candesartan with a partition coefficient (logP) of 4.02 and valsartan with a partition coefficient of 3.68. Only the lipophilic of the circulating active drug is relevant for tissue penetration after the drug is absorbed.…”

Section: Analysis Of the Use Of Antihypertensives Angiotensin Recepto...mentioning

confidence: 96%

Monitoring Kidney Function Through the Use of Candesartan, Telmisartan or Valsartan Antihypertensive Therapy towards Patients CKD

Fandinata

Darmawan

Utami³

et al. 2022

MKMI

View full text Add to dashboard Cite

Chronic Kidney Disease (CKD) lower kidney function caused by an irreversible reduction in normal nephron function. Globally, CKD contributes to the cause of death. Activation of the Renin-Angiotensin-Aldosterone system is involved in the pathogenesis. ARBs have a cardiorenal protective effect. The purpose of this study was to determine the changes in kidney function with the use of Candesartan, Telmisartan or Valsartan antihypertensive therapies in CKD patients. This research method was a prospective observational cohort study looking at changes in kidney function (BUN and Serum Creatinine) at 1 and 6 months of using Antihypertensive Drugs Valsartan, Telmisartan, and Candesartan and tested by statistical analysis. The number of samples in this study was 72 patients which are 24 patients (Candesartan), 27 patients (Telmisartan), and 21 patients (Valsartan). The results showed that the Candesartan group experienced a decrease in average BUN of 0.13±0.85 mg/dl and serum creatinine of 0.004±0.09 mg/dl with independent t-test p=0.479 (p>0.05), Serum Creatinine p= 0.809 (p>0.05). The Telmisartan group experienced a decrease in average BUN of 4.74±5.16 mg/dl and serum creatinine of 0.33±0.20 mg/dl with Wilcoxon BUN test results p=0.000 (p<0.05), Serum Creatinine p=0.000 (p<0.05). In contrast, in the valsartan group, there was no change. So, it can be said that telmisartan has the highest effectiveness in kidney function (BUN and Serum Creatinine).

show abstract

Effect of angiotensin receptor blockers on blood pressure and renal function in patients with concomitant hypertension and chronic kidney disease: a systematic review and meta-analysis

Cited by 18 publications

References 91 publications

Changes in the Urinary Metabolites in Losartan-Treated Spontaneously Hypertensive Rats

Changes in the Urinary Metabolites in Losartan-Treated Spontaneously Hypertensive Rats

Sodium–glucose cotransporter 2 inhibitor‐induced reduction in the mean arterial pressure improved renal composite outcomes in type 2 diabetes mellitus patients with chronic kidney disease: A propensity score‐matched model analysis in Japan

Monitoring Kidney Function Through the Use of Candesartan, Telmisartan or Valsartan Antihypertensive Therapy towards Patients CKD

Contact Info

Product

Resources

About