Efficacy and safety of losartan in patients with proteinuria.
The renoprotective effect and safety of an angiotensin II receptor blocker, losartan, were studied in 11 diabetic and 14 nondiabetic patients with a daily urinary protein excretion >500 mg. Once-daily losartan was administered to all patients for 16 weeks without diuretics or other antihypertensive agents. A daily dose of 50 mg was given to those patients with a sitting systolic blood pressure of between 130 and 170 mm Hg; 25 mg was given to patients with a systolic blood pressure of between 110 and 130 mm Hg. Sixteen patients (6 diabetic and 10 nondiabetic patients) had a more than 25% decrease of their daily urinary protein excretion (response rate 64%). The mean decrease in these 16 patients was 57 +/- 17% (p < 0.05). Two patients (1 diabetic and 1 nondiabetic) had more than a 25% increase of their urinary protein excretion. The trough sitting systolic blood pressure of all patients (n = 25) decreased from 142 +/- 17 to 125 +/- 13 mm Hg (p < 0.05) and the trough sitting diastolic blood pressure from 87 +/- 11 to 78 +/- 11 mm Hg (p < 0.05). Serum uric acid was measured in 16 patients; a decrease from 7.3 +/- 1.6 to 6.6 +/- 1.4 mg/dl (a 9.6% decrease, p < 0.05) was found after 16 weeks. Our study showed that in both diabetic and nondiabetic proteinuric patients once-daily losartan, given as monotherapy at doses of 25 or 50 mg, was effective in reducing blood pressure, serum uric acid levels, and daily urinary protein excretions.
Division of Nephrology, Department of Medicine, Shin Kong Wu Ho-Su Memorial Hospital, 2F, 301 Shi-Pai Road, Section 2, Pei-Tou, Taipei 112, Taiwan. jgleu@mailsrv.ym.edu.tw
Jyh-Gang
JG
Leu
Chee-Ming
CM
Huang
Shang-Jyh
SJ
Kao
Wey-Wen
WW
Jiang
D000328:Adult; D000368:Aged; D057911:Angiotensin Receptor Antagonists; D018450:Disease Progression; D005260:Female; D006801:Humans; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000188:drug therapy*; D051437:Renal Insufficiency / Q000503:physiopathology; D012307:Risk Factors
D057911:Angiotensin Receptor Antagonists; D019808:Losartan