Aliskiren reduces morning blood pressure in hypertensive patients with diabetic nephropathy.

Abstract

Diabetic nephropathy (DN) is a leading disease that requires renal replacement therapy. The progression of renal dysfunction in DN is faster than the other renal diseases. While antihypertensive therapy reduces albuminuria, a good indicator for the progression, hypertension in DN is treatment resistant. Among patients with DN who took angiotensin receptor blockers (ARBs), 27 patients who exhibited poor control of albuminuria were enrolled into the study. Angiotensin receptor blocker was exchanged to aliskiren (150-300 mg/d) and clinical parameters were followed for 6 months. Exchange to aliskiren decreased albuminuria (1.57 ± 0.68 to 0.89 ± 0.45 g/gCr, P < .01) without changes in estimated glomerular filtration rate and office blood pressure (BP). Body weight and hemoglobin A1c were not altered. Aliskiren also reduced plasma renin activity (2.0 ± 0.9 to 1.2 ± 0.6 ng/mL/h, P < .01). While evening BP was unchanged, morning systolic BP (139 ± 8 to 132 ± 7 mm Hg, P < .01) and diastolic BP (81 ± 7 to 76 ± 6 mm Hg, P < .05) were decreased significantly after 6 months. Our results indicated that aliskiren decreased BP, especially morning BP in hypertensive patients with DN. The present data suggest that aliskiren exerts renoprotective actions including reduction in albumin excretion for patients with DN.

• Authors: Tsuneo Takenaka, Kanako Nobe, Mika Okayama, Eriko Kojima, Yuka Nodaira, Keita Sueyoshi, Hitoshi Hoshi, Yusuke Watanabe, Hiroshi Takane, Hiromichi Suzuki
• Journal: Clinical and experimental hypertension (New York, N.Y. : 1993) (Clin Exp Hypertens) Vol. 34 Issue 4 Pg. 243-8 ( 2012) ISSN: 1525-6006 [Electronic] England
• PMID: 22559034 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Amides
• Angiotensin II Type 1 Receptor Blockers
• Antihypertensive Agents
• Fumarates
• aliskiren
• Renin

Topics

• Aged
• Albuminuria (drug therapy)
• Amides (therapeutic use)
• Angiotensin II Type 1 Receptor Blockers (therapeutic use)
• Antihypertensive Agents (therapeutic use)
• Blood Pressure (drug effects)
• Circadian Rhythm
• Diabetic Nephropathies (drug therapy, physiopathology)
• Disease Progression
• Female
• Fumarates (therapeutic use)
• Glomerular Filtration Rate (drug effects)
• Humans
• Male
• Middle Aged
• Prospective Studies
• Renin (antagonists & inhibitors)