Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Renoprotection with and without blood pressure reduction

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Low C4 gene copy numbers are associated with superior graft survival in patients transplanted with a deceased donor kidney

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Need for better diabetes treatment for improved renal outcome

    Research output: Contribution to journalReviewResearchpeer-review

  3. Elevated vascular endothelial growth factor in type 1 diabetic patients with diabetic nephropathy

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Role of patient factors in therapy resistance to antiproteinuric intervention in nondiabetic and diabetic nephropathy

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Progression of diabetic nephropathy in normotensive type 1 diabetic patients

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Effects of Dapagliflozin in Patients With Kidney Disease, With and Without Heart Failure

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

BACKGROUND: AT1-receptor blockade dose dependently lowers blood pressure (BP) and albuminuria. Reduction of BP and albuminuria are independent treatment targets for renoprotection, but whether this requires similar dose titration is unknown.

METHODS: We tested this in two studies designed to find the optimal antialbuminuric dose of losartan in type 1 diabetic (DM, N= 50) and nondiabetic renal patients (ND, N= 12). After baseline, treatment followed with losartan 50, 100, and 150 mg/day, each dose for eight (DM) or six weeks (ND). At the end of each period, albuminuria (24-hour samples) and mean arterial pressure (MAP) were measured. Patients were divided into "good" and "poor" BP responders (BP+, BP-) according to BP response above or below group median.

RESULTS: Baseline MAP in the BP- groups was 102 (97, 104) mm Hg in DM (median, 95% CI) and 91 (80, 108) mm Hg in ND. The top of the dose response for BP (obtained at losartan 100 mg) in the BP- groups was -2 (-4, 3) mm Hg in DM and -1 (-6, 2) mm Hg in ND, versus -15 (-18, -12) mm Hg and -16 (-26, -18) mm Hg in BP+ groups (both P < 0.05). Albuminuria was reduced dose dependently both in BP- and BP+: with 100 mg, the reduction in albuminuria in DM BP- was -32% (-49, 13) versus -45% (-60, -38) in DM BP+ and -45% (-70,-7) versus -25% (-58, -6) in ND BP- and BP+ (all P > 0.05). Moreover, in patients in whom BP fell below the recommended treatment target of 130/80 mm Hg (13 in DM and 10 in ND), albuminuria was progressively reduced, with further increasing the dose of losartan in most patients.

CONCLUSION: Absence of BP response to losartan does not preclude a reduction in albuminuria, and optimal reduction of albuminuria may require titration beyond the predefined BP target.

Original languageEnglish
Book seriesKidney International, Supplement
Issue number94
Pages (from-to)S54-9
ISSN0098-6577
DOIs
Publication statusPublished - Apr 2005

    Research areas

  • Adult, Albuminuria, Antihypertensive Agents, Blood Pressure, Female, Humans, Hypertension, Renal, Losartan, Male, Middle Aged, Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't

ID: 52009551