title: Aliskiren, a direct renin inhibitor, improves vascular endothelial function in patients on hemodialysis independent of antihypertensive effect ∼ a pilot study∼.
abstract: OBJECTIVE
  Aliskiren inhibits the first step in the renin-angiotensin system (RAS) and recently has been shown to modulate vascular diseases via RAS-dependent and independent pathways. This study aimed to determine the effect of aliskiren-associated direct renin inhibition on endothelial function in patients on hemodialysis via flow-mediated dilatation (FMD) and platelet-derived microparticles (PDMP), as biomarkers of atherosclerosis.
  
  
  METHODS
  A 12-week prospective study was performed with 24 patients on hemodialysis who were administered 150 mg orally aliskiren once daily for 12 weeks.
  
  
  RESULTS
  No significant difference were observed between pre-dialysis, home, and weekly averaged blood pressure at baseline and at 12 weeks (151.5 ± 8.5/80.9 ± 12.9 mmHg vs 150.3 ± 15.3/78.9 ± 21.2 mmHg, 151.4 ± 9.7/82.3 ± 14.7 mmHg vs 151.2 ± 17.7/81.4 ± 10.6 mmHg, and 156.0 ± 18.3/81.9 ± 9.4 mmHg vs 152.5 ± 18.9/81.7 ± 12.3 mmHg, respectively). FMD significantly increased from 2.54% ± 1.45% at baseline to 3.11% ± 1.37% at 12 weeks (P = 0.0267), and PDMP significantly decreased from 13.9 ± 5.8 U/mL at baseline to 10.9 ± 4.5 U/mL at 12 weeks (P = 0.0002).
  
  
  CONCLUSIONS
  Aliskiren improved vascular endothelial function and platelet-endothelium activation in patients on hemodialysis independent of antihypertensive effect.
authors.affiliation: Department of Nephrology, Immunology, and Vascular Medicine, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan. hidekazu.moriya@tokushukai.jp
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Moriya
authors.forename: Shuzo
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Takayasu
authors.initials: T
authors.lastname: Ohtake
authors.forename: Daimu
authors.initials: D
authors.lastname: Tutumi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Mochida
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Ishioka
authors.forename: Machiko
authors.initials: M
authors.lastname: Oka
authors.forename: Kyoko
authors.initials: K
authors.lastname: Maesato
authors.forename: Sumi
authors.initials: S
authors.lastname: Hidaka
authors.forename: Shosaku
authors.initials: S
authors.lastname: Nomura
mesh_terms: D000368:Aged; D000577:Amides / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001792:Blood Platelets / Q000187:drug effects; D001794:Blood Pressure / Q000502:physiology; D002097:C-Reactive Protein / Q000378:metabolism; D055252:Cell-Derived Microparticles / Q000378:metabolism; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005650:Fumarates / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015539:Platelet Activation / Q000187:drug effects; D006435:Renal Dialysis; D012084:Renin-Angiotensin System / Q000187:drug effects; D014664:Vasodilation / Q000502:physiology; D000092502:Renin Inhibitors
chemical_list: D000577:Amides; D000959:Antihypertensive Agents; D002097:C-Reactive Protein; D005650:Fumarates; D000092502:Renin Inhibitors; C446481:aliskiren