title: Efficacy of aliskiren in Japanese chronic kidney disease patients with hypertension.
abstract: BACKGROUND
  Aliskiren, a novel direct renin inhibitor, is hypothesized to inhibit the renin-angiotensin- system. This study attempted to provide insight into this mechanism by examining the antihypertensive and renoprotective effects of aliskiren in hypertensive chronic kidney disease (CKD) patients.
  
  
  METHODS
  After recruitment, 43 hypertensive CKD patients (mean age, 53.7 years) began treatment of aliskiren. The patients were classified into high (over 30 mL/min/1.73 m(2)) estimated glomerular filtration rate (eGFR) group or low (under 30 mL/min/1.73 m(2)) eGFR group for comparison of measurements of various parameters over the 6-month observation period.
  
  
  RESULTS
  Systolic blood pressure/diastolic blood pressure of 150 mg/day group decreased to an average of 126.8 ± 21.6 mmHg/69.3 ± 15.1 mmHg (average decrease: -7.4/-8.3 mmHg) over the 6-month observation period, while that of 300 mg/day group significantly decreased to an average of 133.5 ± 14.0 mmHg/71.5 ± 11.7 mmHg (average decrease: -21.1/-14.6 mmHg). Urinary protein of all patients decreased slightly and insignificantly to 1.1 ± 1.7 g/gCr from 1.4 ± 2.5 g/gCr. The serum creatinine (Cr) level of all patients decreased from 1.81 ± 1.10 mg/dL to 1.78 ± 0.82 mg/dL. Although the serum Cr level of the high eGFR group decreased from 1.28 ± 0.45 mg/dL to 1.27 ± 0.57 mg/dL, that of the low eGFR group slightly but insignificantly increased from 2.49 ± 0.64 mg/dL to 2.69 ± 1.11 mg/dL.
  
  
  CONCLUSIONS
  Administration of aliskiren exerts an antihypertensive effect on hypertensive CKD patients that may lead to a decrease in urinary protein and an improvement in renal functioning.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Nippon Medical School Musashikosugi Hospital, Kawasaki, Japan. y-sakai@nms.ac.jp
authors.forename: Yukinao
authors.initials: Y
authors.lastname: Sakai
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Otsuka
authors.forename: Dai
authors.initials: D
authors.lastname: Ohno
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Murasawa
authors.forename: Naoki
authors.initials: N
authors.lastname: Sato
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Mizuno
mesh_terms: D000368:Aged; D000577:Amides / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005650:Fumarates / Q000008:administration & dosage*; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012084:Renin-Angiotensin System / Q000187:drug effects* / Q000502:physiology; D016896:Treatment Outcome; D000092502:Renin Inhibitors
chemical_list: D000577:Amides; D005650:Fumarates; D000092502:Renin Inhibitors; C446481:aliskiren