Abstract:
BACKGROUND:Blocking the renin-angiotensin system (RAS) with angiotensin receptor blockers or angiotensin-converting enzyme inhibitors protects against renal injury in patients with chronic kidney disease (CKD). The aim of this study was to compare the chronic effects of telmisartan and enalapril on proteinuria, urinary liver-type fatty acid-binding protein (L-FABP) and endothelin (ET)-1 levels in patients with mild CKD. MATERIALS AND METHODS:Thirty CKD patients with mild to moderate renal insufficiency (20 men and 10 women; mean age, 37 years; estimated glomerular filtration rate (eGFR) > 60 mL min(-1) and blood pressure > 130/85 mmHg) were included in the study. Patients were randomly assigned to receive telmisartan at 80 mg day(-1) (n = 15) or enalapril at 10 mg day(-1) (n = 15). We measured blood pressure, serum creatinine, eGFR, urinary protein, L-FABP and ET-1 before the start of treatment and 6 and 12 months after the start of treatment. RESULTS:The blood pressure reduction rate was similar between the two groups. Urinary protein, L-FABP and ET-1 levels were significantly reduced in both groups 6 and 12 months (P < 0.001) after treatment, but the reduction rates were more pronounced in patients receiving telmisartan than in those receiving enalapril (P < 0.001). Estimated glomerular filtration rate was increased similarly in both groups at 12 months. CONCLUSIONS:The study results suggest that telmisartan results in a greater reduction of urinary markers than does enalapril and that this effect occurs by a mechanism independent of blood pressure reduction. It would be needed to investigate whether the differences may be distinct or not the same when other dosages are used.
journal_name
Eur J Clin Investjournal_title
European journal of clinical investigationauthors
Nakamura T,Fujiwara N,Kawagoe Y,Sugaya T,Ueda Y,Koide Hdoi
10.1111/j.1365-2362.2010.02319.xsubject
Has Abstractpub_date
2010-09-01 00:00:00pages
790-6issue
9eissn
0014-2972issn
1365-2362pii
ECI2319journal_volume
40pub_type
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journal_title:European journal of clinical investigation
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journal_title:European journal of clinical investigation
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journal_title:European journal of clinical investigation
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journal_title:European journal of clinical investigation
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