Effects of angiotensin II receptor blocker on proteinuria in renal transplant recipients.
BACKGROUND
Therapeutic approaches directed at reducing proteinuria are under development. The aim of the present study was to prospectively elucidate the impact of losartan treatment in renal transplant recipients with persistent proteinuria.


METHODS
Twenty-eight patients with persistent proteinuria or mild hypertension were assigned to receive losartan. Proteinuria was defined as a ratio of urinary protein to urinary creatinine (U(P)/U(Cr)) >0.5 in continual urinary tests in the outpatient setting.


RESULTS
All patients with mild hypertension reached target blood pressure (BP) with losartan treatment, but the change was not significant. In twelve patients with proteinuria before initiation of the study, urinary protein excretion was significantly reduced with treatment. No correlation was observed between reductions in proteinuria and mean BP. A significant decrease was identified in the hemoglobin concentration of patients with serum creatinine concentrations >2.0 mg/dl before the study.


CONCLUSIONS
Losartan efficiently reduces proteinuria in renal transplant recipients with adequate tolerance. Multicentric prospective studies are required to confirm its clinical effectiveness.
Tanji
Nozomu
N
Department of Urology, Ehime University School of Medicine, Onsen-gun, Ehime 791-0295, Japan. tanji@m.ehime-u.ac.jp
Ohoka
Hiroji
H
Shimamoto
Kenji
K
Ikeda
Tetsuhiro
T
Miyauchi
Yuuki
Y
Yokoyama
Masayoshi
M
D000328:Adult; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology; D016030:Kidney Transplantation / Q000009:adverse effects; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D010045:Outpatients; D011183:Postoperative Complications / Q000188:drug therapy*; D011507:Proteinuria / Q000188:drug therapy* / Q000209:etiology
D047228:Angiotensin II Type 1 Receptor Blockers; D019808:Losartan