title: Long-term renoprotective effects of standard versus high doses of telmisartan in hypertensive nondiabetic nephropathies.
abstract: BACKGROUND
  This report describes an open randomized study intended to evaluate the long-term renoprotective effects of "standard" (80 mg once daily) versus "high" (80 mg twice daily) doses of telmisartan in hypertensive patients without diabetes with biopsy-proven chronic proteinuric nephropathies.
  
  
  METHODS
  We included 78 patients (age, 43.5 +/- 13.2 years; 71.8% men). After a 4-week wash-out period, patients were randomly assigned to telmisartan, 80 mg once daily (n = 40) or 80 mg twice daily (n = 38), during a mean follow-up of 24.6 +/- 2.2 months.
  
  
  RESULTS
  Baseline characteristics were similar in both groups, including blood pressure, renal function, and proteinuria. Blood pressure control did not differ between groups during follow-up. In the group administered telmisartan, 80 mg once daily, serum creatinine level increased from 1.6 +/- 0.6 to 2.7 +/- 0.9 mg/dL (141 +/- 52 to 239 +/- 80 micromol/L), and estimated creatinine clearance declined from 68 +/- 30 to 50 +/- 34 mL/min (1.13 +/- 0.50 to 0.83 +/- 0.57 mL/s), whereas in those administered 80 mg twice daily, serum creatinine (1.6 +/- 0.7 to 1.6 +/- 0.8 mg/dL [141 +/- 62 to 141 +/- 71 micromol/L]) and estimated creatinine clearance values (67 +/- 38 to 74 +/- 38 mL/min [1.12 +/- 0.63 to 1.23 +/- 0.63 mL/s]) did not change during the study. The decrease in proteinuria was more pronounced (P < 0.01) in patients administered the high dose of telmisartan compared with those treated with the standard dose. Serum potassium levels and lipid profiles did not change significantly in either group.
  
  
  CONCLUSIONS
  Long-term administration of high doses of telmisartan seems to improve the efficacy of the drug to decrease proteinuria and slow the progression to end-stage renal failure in nondiabetic hypertensive renal disease.
authors.affiliation: Nephrology Department, Hospital Regional Universitario Carlos Haya, Málaga, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Aranda
authors.forename: Julian
authors.initials: J
authors.lastname: Segura
authors.forename: Luis M
authors.initials: LM
authors.lastname: Ruilope
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Aranda
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Frutos
authors.forename: Verónica
authors.initials: V
authors.lastname: López
authors.forename: Eduardo
authors.initials: E
authors.lastname: López de Novales
mesh_terms: D000328:Adult; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D001565:Benzoates / Q000008:administration & dosage / Q000627:therapeutic use*; D003404:Creatinine / Q000097:blood; D004305:Dose-Response Relationship, Drug; D050171:Dyslipidemias / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D007674:Kidney Diseases / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000209:etiology; D012084:Renin-Angiotensin System / Q000502:physiology; D000077333:Telmisartan; D016896:Treatment Outcome
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001565:Benzoates; D003404:Creatinine; D000077333:Telmisartan