Effect of telmisartan on kidney function in patients with chronic kidney disease: an observational study

Abstract

Background: Globally the burden of chronic kidney disease (CKD) is rising, an important cause of death and loss of disability-adjusted life years. Activation of the renin-angiotensin-aldosterone system is involved in its pathogenesis. The aim of the present study was to examine the effects of telmisartan (40 mg/day), an angiotensin receptor blocker (ARB) in Indian patients with CKD in real-life setting. Method: This was a prospective observational study. Fifty-six patients (>18 years) diagnosed with CKD were enrolled into the study. Serum creatinine, 24-h urinary protein, spot urine protein-to-creatinine ratio, glomerular filtration rate (GFR) and blood pressure (BP) were assessed along with safety. Results: A total of 55 patients (96.36% hypertensive; 63.61% diabetic) with mean age of 48.23 years completed the study. At the end of 3 months treatment with telmisartan, 24-h urinary protein, spot urine protein-to-creatinine, serum creatinine and BP significantly reduced (p < .05) by 806.78 mg, 0.95, 0.44 mg/dl and 8.9/4.7 mmHg in the overall population. GFR increased from the baseline value of 52.13 to 65.01 ml/min. Telmisartan was well tolerated and treatment was discontinued in one patient because of hyperkalemia. Conclusion: This study demonstrated that telmisartan effectively and safely reduces proteinuria in chronic kidney disease patients.

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

“…On the use of telmisartan 40 mg once daily for 12 months and the reduction was significantly greater than in the amlodipine group (p<0.05). 22 So, in this study showed that telmisartan is effective in the progression of kidney function (BUN and Serum Creatinine) in CKD patients. Based on the results of the study, the impact of public health, especially in health services, is to provide information to medical personnel about the effectiveness of using antihypertensive drugs so that they can improve the quality of services to the community and prevent disease progression.…”

“…The maximum blood pressure-lowering effect occurs about 4 to 8 weeks after starting therapy. 22 Telmisartan is rapidly absorbed from the gastrointestinal tract. Oral bioavailability is dosedependent, about 42% after a 40 mg dose and 58% after 160 mg.…”

Effect of angiotensin II receptor blocker therapy on markers of fibrosis and immune inflammation in hypertensive patients with chronic kidney disease after ischemic stroke

“…Известно, что активация РААС, особенно АТ-II, участвует в патогенезе как артериальной гипертензии, так и ХБП [18]. При ХБП БРА являются предпочтительными, поскольку они обладают антипротеинурическим действием вне зависимости от достигнутого уровня АД, за счет селективной блокады АТ рецептора 1 типа [18].…”

“…фармакотерапии результаты свидетельствуют о более выраженном противовоспалительном эффекте телмисартана по сравнению с азилсартаном у больных ГБ на фоне ХБП с ИИ. В литературе существуют противоречивые данные в отношении уровня креатинина при применении телмисартана, некоторые авторы сообщали об отсутствии изменений в процессе лечения, в то же время другие выявили снижение этого показателя [18,34,35]. В исследовании Agrawal А, et al (2016) 55 пациентов с ХБП получали телмисартан в дозе 40 мг/сут.…”

“…и через 3 мес. лечения наблюдалось значительное снижение белка в моче, креатинина сыворотки, АД и повышение СКФ [18]. Результаты исследования ACCOMPLISH (Avoi ding Cardiovascular events through Combination therapy in Patients Living with Systolic Hypertension) показали, что сохранение СКФ важно для подавления прогрессирования ХБП [36].…”