title: A retrospective Aliskiren and Losartan study in non-diabetic chronic kidney disease.
abstract: OBJECTIVE
  To assess the efficacy of combined Aliskiren and Losartan vs high dose Losartan and Aliskiren alone in chronic kidney disease (CKD).
  
  
  METHODS
  This is a retrospective study of 143 patients with non-diabetic CKD comparing combined Aliskiren (150 mg/d) with Losartan (100 mg/d) therapy vs High dose Angiotensin receptor blockers (ARB) (Losartan 200 mg/d) and the third group Aliskiren (150 mg/d) alone. This study involved only patient medical records. Entry criteria included those patients who had been treated with the above drugs for at least 36 mo within the 5 years period; other criteria included proteinuria of 1 g or more and or CKD Stage 3 at the start of the 36 mo period. The study utilised primary renal end points of estimated Glomerular Filtration Rate (eGFR) < 15 mL/min or end stage renal failure.
  
  
  RESULTS
  Patients treated with high dose ARB compared to the other two treatment groups had significantly less proteinuria at the end of 36 mo (P < 0.007). All 3 groups had significant reduction of proteinuria (P < 0.043, P < 0.001). Total urinary protein was significantly different between the 3 groups over the 3-year study period (P = 0.008), but not eGFR. The changes in eGFR from baseline to each year were not significantly different between the 3 therapeutic groups (P < 0.119). There were no significant differences in the systolic and diastolic blood pressure between the 3 drug groups throughout the 3 years. The incidence of hyperkalemia (> 5.5 mmol/L) was 14.2% (7/49) in the Combined Aliskiren and ARB group, 8.7% (4/46) in the Aliskiren alone group and 6.3% (3/48) in the High dose ARB group (P < 0.001).
  
  
  CONCLUSIONS
  This study in non-diabetic CKD patients showed that Combination therapy with Aliskiren and ARB was effective but was not safe as it was associated with a high prevalence of hyperkalaemia.
authors.affiliation: Keng-Thye Woo, Hui-Lin Choong, Kok-Seng Wong, Han- Kim Tan, Marjorie Foo, Grace SL Lee, Choong-Meng Chan, Department of Renal Medicine, Singapore General Hospital, 169608, Singapore.
authors.forename: Keng-Thye
authors.initials: KT
authors.lastname: Woo
authors.forename: Hui-Lin
authors.initials: HL
authors.lastname: Choong
authors.forename: Kok-Seng
authors.initials: KS
authors.lastname: Wong
authors.forename: Han-Kim
authors.initials: HK
authors.lastname: Tan
authors.forename: Marjorie
authors.initials: M
authors.lastname: Foo
authors.forename: Fook-Chong
authors.initials: FC
authors.lastname: Stephanie
authors.forename: Evan Jc
authors.initials: EJ
authors.lastname: Lee
authors.forename: Vathsala
authors.initials: V
authors.lastname: Anantharaman
authors.forename: Grace Sl
authors.initials: GS
authors.lastname: Lee
authors.forename: Choong-Meng
authors.initials: CM
authors.lastname: Chan
keywords: Aliskiren; Chronic kidney disease disease; Clinical trial