title: Comparison of once daily versus twice daily olmesartan in patients with chronic kidney disease.
abstract: BACKGROUND
  The effects of olmesartan (OLM) on blood pressure and kidney function in Japanese patients with chronic kidney disease (CKD) were compared between 20 mg twice daily (BID) and 40 mg once daily (QD) treatments.
  
  
  METHODS
  The subjects were Japanese CKD patients with concurrent hypertension who had been treated with OLM 20 mg BID for at least 3 months on an outpatient basis (n=39). After a change in the treatment regimen to 40 mg OLM QD (after breakfast), blood pressure (BP) (n=39), morning home BP (n=13), estimated glomerular filtration rate (n=39), and urinary albumin-to-creatinine ratio (n=17) were monitored for 2 months.
  
  
  RESULTS
  No significant change in office (mean ± standard deviation [SD] [mmHg], 143.9 ± 18.8/75.7 ± 12.0 to 141.6 ± 16.1/74.7 ± 11.7, not significant [ns]) or early morning home (mean ± SD [mmHg], 133.8 ± 15.9/71.2 ± 11.5 to 133.8 ± 13.9/74.5 ± 10.5, ns) BP was observed 2 months after the change in dose. The estimated glomerular filtration rate increased significantly (mean ± SD, 49.0 ± 28.0 to 51.8 ± 27.0, P<0.05), whereas urinary albumin-to-creatinine ratio did not change significantly (mean ± SD, 0.551 ± 0.445 to 0.364 ± 0.5194, ns).
  
  
  CONCLUSIONS
  High-dose OLM administered BID and QD had similar effects on outpatient and early morning home BP in CKD patients, suggesting that the BID regimen can be safely changed to a QD regimen. For CKD patients with hypertension requiring continuous long-term treatment, the possibility that the QD regimen might bring a greater therapeutic effect was suggested. However, recognizing the best blood pressure control level for a CKD patient is still a matter of debate, and should ideally be personalized.
authors.affiliation: Department of Nephrology, Nippon Medical School Musashikosugi Hospital, Kawasaki, Japan.
authors.forename: Yukinao
authors.initials: Y
authors.lastname: Sakai
authors.forename: Anna
authors.initials: A
authors.lastname: Suzuki
authors.forename: Koji
authors.initials: K
authors.lastname: Mugishima
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Sumi
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Otsuka
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: Shuichi
authors.initials: S
authors.lastname: Tsuruoka
keywords: chronic kidney disease; compliance; high-dose angiotensin receptor blocker; hypertension; olmesartan