Abstract | BACKGROUND AND OBJECTIVES: Elevated BP contributes to development and progression of proteinuria and decline in renal function in patients with type 2 diabetes. Our post hoc analysis assessed the baseline BP influence on the antiproteinuric effect in the Aliskiren in the Evaluation of Proteinuria in Diabetes (AVOID) study. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In the AVOID study, 599 hypertensive type 2 diabetic patients with nephropathy received 6 months of aliskiren (150 mg force titrated to 300 mg daily after 3 months) or placebo added to losartan (100 mg) daily and optimal antihypertensive therapy. Changes in early morning urinary albumin: creatinine ratio and eGFR at week 24 were assessed by subgroups of baseline BP: Group A (prespecified target), <130/80 mmHg (n=159); Group B, <140/90 mmHg but ≥130/80 mmHg (n=189); and Group C (insufficient BP control), ≥140/90 mmHg (n=251). RESULTS: Mean baseline BP (mmHg) levels for Groups A, B, and C were 120/71, 133/78, and 145/81, respectively. BP during the trial was nearly identical to baseline levels in all groups. The antiproteinuric effects of aliskiren were consistent across subgroups of baseline BP (19 to 22% reduction versus placebo). In Group C, the decline in eGFR was significantly lower with aliskiren than with placebo (P=0.013). CONCLUSIONS:
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Authors | Frederik Persson, Julia B Lewis, Edmund J Lewis, Peter Rossing, Norman K Hollenberg, Hans-Henrik Parving |
Journal | Clinical journal of the American Society of Nephrology : CJASN
(Clin J Am Soc Nephrol)
Vol. 6
Issue 5
Pg. 1025-31
(May 2011)
ISSN: 1555-905X [Electronic] United States |
PMID | 21350110
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2011 by the American Society of Nephrology |
Chemical References |
- Amides
- Antihypertensive Agents
- Fumarates
- Placebos
- aliskiren
- Losartan
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Topics |
- Aged
- Albuminuria
(drug therapy, physiopathology)
- Amides
(administration & dosage, adverse effects)
- Antihypertensive Agents
(administration & dosage, adverse effects)
- Blood Pressure
(drug effects, physiology)
- Diabetes Mellitus, Type 2
(drug therapy, physiopathology)
- Diabetic Nephropathies
(drug therapy, physiopathology)
- Drug Therapy, Combination
- Female
- Fumarates
(administration & dosage, adverse effects)
- Humans
- Hypertension, Renal
(drug therapy, physiopathology)
- Losartan
(administration & dosage, adverse effects)
- Male
- Middle Aged
- Placebos
- Treatment Outcome
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