Losartan, an Angiotensin-II Receptor Antagonist, Retards the Progression of Advanced Renal Insufficiency

Abstract

Chronic renal disease with elevated level of serum creatinine (Cr) often progresses to end-stage renal disease. Although blockade of the renin-angiotensin system has been shown to slow the progression of chronic renal disease, it remains uncertain whether one could expect such a renoprotective effect even when the treatment is initiated late in the course of renal disease. The purpose of the present study was to examine the effect of losartan, an angiotensin-II receptor antagonist, on the progression of advanced renal insufficiency. We retrospectively analyzed eight hypertensive patients, whose baseline Cr levels exceeded 2.0 mg/dl (2.2-5.5); the subjects included 6 non-diabetic glomerular diseases, 1 diabetic nephropathy and 1 polycystic kidney disease. Losartan was given at the dosage of 25-50 mg/day. Changes in mean blood pressure (MBP) and serum levels of Cr, potassium (K) and uric acid were evaluated after treatment for 24 weeks. Slopes of reciprocal of serum Cr plotted against time (1/sCr slope), which indicate the rate of renal function loss before and after the treatment period, were compared. There was a significant reduction of 1/sCr slope after losartan (−0.004 ± 0.002 dl/mg/week before and −0.001 ± 0.002 dl/mg/week after the treatment, p < 0.05). MBP and serum levels of Cr, K and uric acid were not changed significantly by losartan treatment. However, improvement of 1/sCr slope was correlated to the degree of MBP changes. Based on the available data from 4 patients, proteinuria was decreased in 3 patients. These results suggest that losartan may retard the progression of advanced renal insufficiency. losartan; renoprotection; advanced renal insufficiency

Seasonal Variation in Estimated Glomerular Filtration Rate Based on Serum Creatinine Levels in Hypertensive Patients

“…Therefore, in hypertensive patients, anti-hypertensive drugs (Whitworth et al 1992;Osawa et al 2006) and improvement of lifestyle (Orth et al 2001) are recommended to prevent the onset or progression of CKD. The National Kidney Foundation formed a task force to heighten awareness of cardiovascular disease in CKD, and defined CKD using parameters such as a decrease in glomerular filtration rate < 60 mL/min/1.73 m 2 .…”

Prevalence, risk factors and disease knowledge of polycystic kidney disease in Pakistan

“…69,70 The antihypertensive drugs having least side effects and marked reno-protection are ACE inhibitors or angiotensin receptor blockers that induce increase in renal blood flow, 71,72 reduction in proteinuria and left ventricular hypertrophy thus improve renal functions. [73][74][75] Renal calculi are conservatively treated by hydration therapy and alkalinization but radiation therapy has good results without serious complications variable methods are available that is, extracorporeal shockwave lithotripsy and percutaneous nephrostolithotomy. Hemorrhage is treated by bed rest, analgesics and hydration therapy but in case of excessive bleeding or hematoma formation, segmental artery embolization is indicated.…”