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Low-grade albuminuria reduction with angiotensin II type 1 receptor blocker in renal transplant recipients.

AbstractBACKGROUND:
Microalbuminuria, defined as urine albumin to urine creatinine ratio of 30 to <300 mg/g, is an established risk factor for cardiovascular morbidity and mortality in the general population. Low-grade albuminuria (<30 mg/g) is considered a marker for subclinical vascular damage that predisposes to future cardiovascular diseases and death. Lowering urinary albumin excretion reduces the risk of cardiovascular disease. Our study was designed to evaluate the influence of angiotensin II type 1 receptor blocker (ARB) in normotensive renal transplant recipients with low-grade albuminuria.
PATIENTS AND METHODS:
Our 6-month prospective observation study used a randomized control and open-label design as we examined the effects of an ARB (valsartan) on blood pressure, urinary albumin excretion, hematocrit, serum potassium and estimated glomerular filtration rate (eGFR) in normotensive recipients with allografts of more than 1 year. A total of 35 renal transplant recipients were enrolled in this study. Patients were randomly assigned to 2 groups: ARB group (n=18), receiving 40-80 mg valsartan daily for 6 months, and the control group (n=17).
RESULTS:
In the ARB group, urine albumin excretion was significantly reduced from 25.9 ± 19.1 mg/g to 12.0 ± 9.6 mg/g at 6 months after administration. eGFR decreased slightly at 6 months after administration. However, no patients undergoing treatment for adverse effects required discontinuation of ARB.
CONCLUSIONS:
This study reveals that ARB is safe and reduces low-grade albuminuria in normotensive renal transplant recipients. Thus, early treatment of ARB in recipients with low-grade albuminuria may prevent cardiovascular disease after renal transplantation.
AuthorsJunji Uchida, Yuichi Machida, Tomoaki Iwai, Taro Iguchi, Yoshiko Kamada, Toshihide Naganuma, Norihiko Kumada, Taku Kim, Hidenori Kawashima, Tatsuya Nakatani
JournalJournal of nephrology (J Nephrol) 2011 Jul-Aug Vol. 24 Issue 4 Pg. 515-21 ISSN: 1724-6059 [Electronic] Italy
PMID21240871 (Publication Type: Journal Article, Randomized Controlled Trial)
Chemical References
  • Angiotensin II Type 1 Receptor Blockers
  • Tetrazoles
  • Valsartan
  • Creatinine
  • Valine
  • Potassium
Topics
  • Adult
  • Albuminuria (drug therapy, urine)
  • Angiotensin II Type 1 Receptor Blockers (pharmacology, therapeutic use)
  • Blood Pressure (drug effects)
  • Creatinine (blood)
  • Female
  • Glomerular Filtration Rate (drug effects)
  • Hematocrit
  • Humans
  • Kidney Transplantation
  • Male
  • Middle Aged
  • Potassium (blood)
  • Prospective Studies
  • Tetrazoles (pharmacology, therapeutic use)
  • Valine (analogs & derivatives, pharmacology, therapeutic use)
  • Valsartan

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