Effect of angiotensin II type-1 receptor blockers on stable allograft kidneys: prospective randomized study.
OBJECTIVE
Is assess the effects of angiotensin II type-I receptor blockers on outcomes in renal transplant recipients without proteinuria or posttransplantation erythrocytosis.


METHODS
Fifty renal transplant recipients (30 men and 20 women, with a mean [SD] age of 40 [13] years) were randomized into 2 groups of 25 patients each; 1 group was treated with losartan for 1 year, and the other was not (control group). Blood pressure and other biochemical parameters were measured at baseline and at 6 and 12 months posttransplantation.


RESULTS
After 1 year, the losartan group had significantly lower systolic blood pressure (113 [22] mm Hg vs 126 [18] mm Hg; P = .04) and hemoglobin concentration (12.8 [1.9] g/dL vs 14.5 [2.1] g/dL; P = .006) and significantly higher serum high-density lipoprotein cholesterol concentration (58 [22] mg/dL vs 47 [10] mg/dL; P = .03) compared with the control group; however the incidence of anemia did not differ (37% vs 20%; P = .20). In the losartan group, there were significant changes in hemoglobin concentration between baseline and 6 months (14.5 [1.6] g/dL vs 12.9 [1.49] g/dL; P < .001), but not between 6 and 12 months (12.9 [1.49] g/dL vs 12.8 [1.96] g/dL; P = .43). After 1 year, there were no significant between-group differences in diastolic hypertension, serum creatinine concentration, creatinine clearance, and serum potassium, low-density lipoprotein cholesterol, triglyceride, and uric acid concentrations.


CONCLUSIONS
Losartan significantly increased high-density lipoprotein concentration and significantly decreased systolic hypertension. Although losartan decreased the hemoglobin concentration during the first 6 months, its effect did not progress with longer use. To determine the effect of losartan on renal function, additional studies with longer follow-up are needed.
Nouri-Majalan
N
N
Nephrology Department, Sadoughi Medical University, Azad University, Yazd, Iran. dr_nori_majelan@yahoo.com
Ghafari
A
A
Moghaddasi
S
S
D000328:Adult; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D008076:Cholesterol, HDL / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011086:Polycythemia / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology; D011183:Postoperative Complications / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology; D011188:Potassium / Q000097:blood; D011446:Prospective Studies; D013599:Systole / Q000187:drug effects; D014184:Transplantation, Homologous
D047228:Angiotensin II Type 1 Receptor Blockers; D008076:Cholesterol, HDL; D003404:Creatinine; D019808:Losartan; D011188:Potassium