title: Effect of aliskiren on proteinuria in non-diabetic chronic kidney disease: a double-blind, crossover, randomised, controlled trial.
abstract: OBJECTIVE
  To evaluate the proteinuria-lowering effect of a renin inhibitor (aliskiren), compared to placebo and to an angiotensin-converting enzyme inhibitor (perindopril), in patients with non-diabetic chronic kidney disease.
  
  
  METHODS
  A randomised, double-blind, crossover trial was performed in 14 patients with nondiabetic chronic kidney disease with 24-h mean proteinuria of 2.01 g (95% CI, 1.36–2.66) and estimated creatinine clearance of 93±6.8 ml/min. The study consisted of five treatment periods. The patients were randomly assigned to receive aliskiren (150 mg), aliskiren (300 mg), perindopril (5 mg), perindopril (10 mg) or placebo.
  
  
  RESULTS
  Aliskiren and perindopril reduced proteinuria. These effects were dose-dependent. Furthermore, 24-h proteinuria was reduced by 23% (mean 95% CI; 2–44) by treatment with aliskiren (150 mg), by 36% (95% CI, 17–55; P<0.001) with aliskiren (300 mg), by 7.1% (95% CI, 11–26) with perindopril (5 mg) and by 25% (95% CI, 11–39; P<0.05) with perindopril (10 mg), compared to placebo. No significant difference was found between the effects of aliskiren and perindopril.
  
  
  CONCLUSIONS
  Aliskiren significantly reduced proteinuria. The antiproteinuric effect is probably similar to that of perindopril, for equivalent hypotensive dosages. The renin inhibitor provides a promising alternative approach for the treatment of patients with chronic proteinuric non-diabetic kidney disease.
authors: Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland. slizak@gumed.edu.pl
authors: Sławomir
authors: S
authors: Lizakowski
authors: Leszek
authors: L
authors: Tylicki
authors: Marcin
authors: M
authors: Renke
authors: Przemysław
authors: P
authors: Rutkowski
authors: Zbigniew
authors: Z
authors: Heleniak
authors: Maja
authors: M
authors: Sławińska-Morawska
authors: Ewa
authors: E
authors: Aleksandrowicz
authors: Wieslawa
authors: W
authors: Łysiak-Szydłowska
authors: Bolesław
authors: B
authors: Rutkowski
mesh_terms: D000328:Adult; D000577:Amides / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005650:Fumarates / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011507:Proteinuria / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology; D000092502:Renin Inhibitors
chemical_list: D000577:Amides; D005650:Fumarates; D000092502:Renin Inhibitors; C446481:aliskiren