Differing anti-proteinuric action of candesartan and losartan in chronic renal disease

Hiroto Matsuda, Koichi Hayashi, Koichiro Honma, Kyoko Yoshioka, Takeshi Kanda, Ichiro Takamatsu, Satoru Tatematsu, Shu Wakino, Takao Saruta

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

It has becoming clear that angiotensin receptor blockers (ARBs) show varying levels of angiotensin II type 1 (AT1) receptor blocking activity. Although the duration of activity and the efficacy on blood pressure of ARB are reported to vary, depending on the agents used, it has not been examined whether the effects on proteinuria and urinary nitrite/nitrate (NOx) excretion differ in hypertensive patients with chronic renal disease. In the present study, patients with hypertension (>140 and/or 90 mmHg) and chronic renal disease (proteinuria >0.5 g/day; serum creatinine <265 μmol/l or creatinine clearance >30ml/min/1.72m2) were randomly assigned to perindopril- (n=15), trandolapril- (n=15), candesartan- (n=17), and losartan-treated groups (n=15), and were followed up for 96 weeks. All agents decreased blood pressure to the same level, and none of them had any effect on creatinine clearance. Candesartan, perindopril, and trandolapril reduced proteinuria markedly (from 3.0±0.6 to 1.8±0.5 g/day, 2.7±0.5 to 1.6±0.4 g/day, and 2.7±0.5 to 1.7±0.4 g/day, respectively) at 12 weeks, and the beneficial effect persisted throughout the study. The effect of losartan, however, diminished over the study period. Whereas perindopril, trandolapril, and candesartan markedly increased urinary NOx excretion (from 257±23 to 1,011±150 μmol/day, 265±70 to 986±130 μmol/day, and 260±62 to 967±67 μmol/day at 12 weeks, respectively), a relatively blunted increase was observed with losartan (from 309±42 to 596±64 μmol/day). In conclusion, renal action of ARB varies, with relatively less proteinuriasparing, as well as NOx-enhancing, effects observed with candesartan showing the greatest reduction of proteinuria and greatest enhancement of NOx. Furthermore, renal nitric oxide may contribute to the renal protective action of these agents when administered to patients with chronic renal disease.

Original languageEnglish
Pages (from-to)875-880
Number of pages6
JournalHypertension Research
Volume26
Issue number11
DOIs
Publication statusPublished - 2003 Nov

Fingerprint

trandolapril
Losartan
Perindopril
Chronic Renal Insufficiency
Proteinuria
Angiotensin Receptor Antagonists
Kidney
Creatinine
Blood Pressure
Protective Agents
Angiotensin Type 1 Receptor
Nitrites
Nitrates
Nitric Oxide
Hypertension
candesartan
Serum

Keywords

  • Angiotensin receptor blockers
  • Candesartan
  • Chronic renal disease
  • Losartan
  • Nitric oxide

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Differing anti-proteinuric action of candesartan and losartan in chronic renal disease. / Matsuda, Hiroto; Hayashi, Koichi; Honma, Koichiro; Yoshioka, Kyoko; Kanda, Takeshi; Takamatsu, Ichiro; Tatematsu, Satoru; Wakino, Shu; Saruta, Takao.

In: Hypertension Research, Vol. 26, No. 11, 11.2003, p. 875-880.

Research output: Contribution to journalArticle

Matsuda, H, Hayashi, K, Honma, K, Yoshioka, K, Kanda, T, Takamatsu, I, Tatematsu, S, Wakino, S & Saruta, T 2003, 'Differing anti-proteinuric action of candesartan and losartan in chronic renal disease', Hypertension Research, vol. 26, no. 11, pp. 875-880. https://doi.org/10.1291/hypres.26.875
Matsuda, Hiroto ; Hayashi, Koichi ; Honma, Koichiro ; Yoshioka, Kyoko ; Kanda, Takeshi ; Takamatsu, Ichiro ; Tatematsu, Satoru ; Wakino, Shu ; Saruta, Takao. / Differing anti-proteinuric action of candesartan and losartan in chronic renal disease. In: Hypertension Research. 2003 ; Vol. 26, No. 11. pp. 875-880.
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