title: Beneficial effect of aliskiren combined with olmesartan in reducing urinary protein excretion in patients with chronic kidney disease.
abstract: BACKGROUND
  Blockade of the renin-angiotensin-aldosterone system is a therapeutic mainstay in patients with chronic kidney disease (CKD). However, the renoprotective effect of the novel direct renin inhibitor aliskiren is unknown.
  
  
  METHODS
  We performed a prospective study in 10 CKD patients. All 10 patients with persistent proteinuria (urinary protein-to-creatinin ratio 0.3-3.5 g/g), despite good blood pressure control (<130/80 mmHg) with olmesartan, were started on 150 mg/day aliskiren. Clinical parameters were examined before and after 4, 8, 12, and 16 weeks of treatment.
  
  
  RESULTS
  Urinary protein-to-creatinine ratio significantly decreased by about 40% at 16 weeks from baseline (P = 0.0002), although estimated glomerular filtration rate and blood pressure did not change throughout the study period. Plasma renin activity also decreased significantly from baseline (P = 0.019), although plasma aldosterone concentration did not change.
  
  
  CONCLUSIONS
  Aliskiren combined with olmesartan reduces proteinuria in CKD patients.
authors.affiliation: Department of Medicine, Kidney Center, Tokyo Women's Medical University, Kawada-cho 8-1, Shinjyuku-ku, Tokyo 162-8666, Japan. takamori@kc.twmu.ac.jp
authors.forename: Takahito
authors.initials: T
authors.lastname: Moriyama
authors.forename: Yuki
authors.initials: Y
authors.lastname: Tsuruta
authors.forename: Chiari
authors.initials: C
authors.lastname: Kojima
authors.forename: Mitsuyo
authors.initials: M
authors.lastname: Itabashi
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Sugiura
authors.forename: Takashi
authors.initials: T
authors.lastname: Takei
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ogawa
authors.forename: Keiko
authors.initials: K
authors.lastname: Uchida
authors.forename: Ken
authors.initials: K
authors.lastname: Tsuchiya
authors.forename: Kosaku
authors.initials: K
authors.lastname: Nitta
mesh_terms: D000328:Adult; D000450:Aldosterone / Q000097:blood; D000577:Amides / Q000494:pharmacology / Q000627:therapeutic use*; D000704:Analysis of Variance; D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003404:Creatinine / Q000652:urine; D004359:Drug Therapy, Combination; D005260:Female; D005650:Fumarates / Q000494:pharmacology / Q000627:therapeutic use*; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007093:Imidazoles / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D000068557:Olmesartan Medoxomil; D011507:Proteinuria / Q000188:drug therapy* / Q000652:urine; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D012083:Renin / Q000097:blood; D013777:Tetrazoles / Q000494:pharmacology / Q000627:therapeutic use*; D055815:Young Adult; D000092502:Renin Inhibitors
chemical_list: D000450:Aldosterone; D000577:Amides; D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D003404:Creatinine; D005650:Fumarates; D007093:Imidazoles; D000068557:Olmesartan Medoxomil; D012083:Renin; D013777:Tetrazoles; D000092502:Renin Inhibitors; C446481:aliskiren