title: Aliskiren reduces morning blood pressure in hypertensive patients with diabetic nephropathy on hemodialysis.
abstract: Our previous study indicated that the exchange from an angiotensin receptor blocker (ARB) to aliskiren reduced morning blood pressure and albuminuria in hypertensive patients with diabetic nephropathy. We extended the above study and assessed the effects of exchanging from an ARB to aliskiren on home blood pressure in hypertensive patients with diabetic nephropathy on chronic hemodialysis. The patients who were persistently hypertensive despite antihypertensive therapy, including ARB, were considered as candidates for the exchange from the ARB to aliskiren. Patients' age and durations of diabetes and hemodialysis were averaged as 62 ± 9 years old, 15 ± 8 and 7 ± 3 years, respectively. Aliskiren decreased morning systolic blood pressure (149 ± 14 to 144 ± 13 mm Hg, n = 30, P < .01) and plasma renin activity (3.5 ± 1.1 to 1.2 ± 0.6 ng/mL/h, P < .01) without changes in serum potassium. Aliskiren also reduced interdialytic weight gain (2.7 ± 0.6 to 2.5 ± 0.5 kg/interval, P < .05) and attenuated the magnitude of intradialytic declines in systolic (-20 ± 11 to -17 ± 10 mm Hg, P < .05) and diastolic blood pressure (-9 ± 6 to -5 ± 5 mm Hg, P < .01). The exchange from an ARB to aliskiren is safe and useful to control home blood pressure in hypertensive hemodialysis patients with diabetic nephropathy. Aliskiren reduced both intradialytic blood pressure drops and interdialytic weight gain in patients with DN.
authors.affiliation: Department of Nephrology, Saitama Medical University, Iruma, Japan. takenaka@saitama-med.ac.jp
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Takenaka
authors.forename: Mika
authors.initials: M
authors.lastname: Okayama
authors.forename: Eriko
authors.initials: E
authors.lastname: Kojima
authors.forename: Yuka
authors.initials: Y
authors.lastname: Nodaira
authors.forename: Jonde
authors.initials: J
authors.lastname: Arai
authors.forename: Kosuke
authors.initials: K
authors.lastname: Uchida
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kikuta
authors.forename: Keita
authors.initials: K
authors.lastname: Sueyoshi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hoshi
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takane
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D000577:Amides / Q000627:therapeutic use*; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002940:Circadian Rhythm / Q000502:physiology; D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005650:Fumarates / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012083:Renin / Q000097:blood; D012189:Retrospective Studies; D015430:Weight Gain / Q000187:drug effects; D000092502:Renin Inhibitors
chemical_list: D000577:Amides; D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents; D005650:Fumarates; D012083:Renin; D000092502:Renin Inhibitors; C446481:aliskiren