Renal effects of losartan and amlodipine in hypertensive patients with non-diabetic nephropathy.
BACKGROUND
The objective of this study was to examine the effects of angiotensin II receptor blocker losartan versus the calcium channel blocker amlodipine on proteinuria, renal haemodynamics, glomerular sieving and tubular function in hypertensive patients with non-diabetic nephropathy.


METHODS
The study design was a prospective, double blind, placebo controlled, randomized crossover trial with amlodipine and losartan. Renal parameters were measured at baseline and at the end of each 4-week active treatment period. Fifteen patients with a diagnosis of non-diabetic renal disease and hypertension were included.


RESULTS
Mean arterial blood pressure decreased from 123+/-13 mmHg at baseline to 113+/-10 mmHg (P<0.01) on losartan and to 114+/-10 mmHg on amlodipine (P<0.01). Urinary albumin excretion significantly decreased from 3510+/-2586 mg/24 h at baseline to 2684+/-2051 mg/24 h (P<0.01) on losartan and increased non-significantly to 3748+/-3355 mg/24 h on amlodipine. Filtration fraction significantly decreased from a baseline value of 22.8+/-9.3% to 21.2+/-10.2% (P<0.05) on losartan and increased to 23.6+/-8.9% (ns) on amlodipine. Either drug did not significantly alter glomerular sieving of neutral dextrans.


CONCLUSIONS
Our results demonstrate that losartan, but not amlodipine, decreased albumin excretion in hypertensive patients with non-diabetic nephropathy.
Holdaas
H
H
Department of Nephrology, National Hospital, University of Oslo, Norway.
Hartmann
A
A
Berg
K J
KJ
Lund
K
K
Fauchald
P
P
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000652:urine; D017311:Amlodipine / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015415:Biomarkers; D001794:Blood Pressure / Q000187:drug effects; D018592:Cross-Over Studies; D003911:Dextrans / Q000493:pharmacokinetics; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D007668:Kidney / Q000187:drug effects* / Q000378:metabolism; D007674:Kidney Diseases / Q000150:complications* / Q000503:physiopathology / Q000652:urine; D019808:Losartan / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D011507:Proteinuria / Q000652:urine
D000959:Antihypertensive Agents; D015415:Biomarkers; D003911:Dextrans; D017311:Amlodipine; D019808:Losartan