title: Predictors of proteinuria reduction by monotherapy with an angiotensin receptor blocker, olmesartan.
abstract: BACKGROUND
  It is known that reduced glomerular filtration rate (GFR) is a crucial factor to limit the blood pressure lowering effect of antihypertensives. In the present study, we tested whether the effects of monotherapy with an angiotensin receptor blocker (ARB) to lower proteinuria could be restricted by reduced GFR.
  
  
  METHODS
  Thirty-five renal patients who had albuminuria more than 30 mg/day, but did not have diabetic nephropathy or nephrotic syndrome, were studied before and during eight weeks of monotherapy with ARB, olmesartan.
  
  
  RESULTS
  Blood pressure was lowered from 129 ± 18/79 ± 12 to 116 ± 18/72 ± 12 mmHg (p < 0.0001), while albuminuria was reduced from 614±630 to 343±472 mg/day (p < 0.0001). Albuminuria was inversely correlated with GFR both before and during treatment. Albuminuria reduction was enhanced as plasma renin activity (p = 0.047) and dose of olmesartan were increased (p = 0.04). Although the absolute reduction in proteinuria was not correlated with GFR (p = 0.56), the % reduction was significantly proportional with GFR (p = 0.027). Multiple regression analysis demonstrated that 64% of proteinuria reduction could be explained by baseline levels of albuminuria, GFR and renin activity.
  
  
  CONCLUSIONS
  The reduction in proteinuria by olmesartan may be roughly predicted using baseline GFR and other parameters. These findings clarify that the effect of ARB on proteinuria reduction is restricted by reduced GFR.
authors.affiliation: Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Minamo
authors.initials: M
authors.lastname: Ono
authors.forename: Michio
authors.initials: M
authors.lastname: Fukuda
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Miura
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizuno
authors.forename: Yoko
authors.initials: Y
authors.lastname: Kato
authors.forename: Ryo
authors.initials: R
authors.lastname: Sato
authors.forename: Takehiro
authors.initials: T
authors.lastname: Naito
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Togawa
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sasakawa
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Tomonari
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Shirasawa
authors.forename: Akinori
authors.initials: A
authors.lastname: Ito
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Yoshida
authors.forename: Genjiro
authors.initials: G
authors.lastname: Kimura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D057911:Angiotensin Receptor Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007093:Imidazoles / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011507:Proteinuria / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D012083:Renin / Q000097:blood; D013777:Tetrazoles / Q000494:pharmacology / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D057911:Angiotensin Receptor Antagonists; D007093:Imidazoles; D013777:Tetrazoles; C437965:olmesartan; D012083:Renin