title: Release from glomerular overload by the addition of low-dose thiazide in patients with angiotensin receptor blocker-resistant hypertension.
abstract: OBJECTIVE
  This multicenter, prospective, observational study assessed the renoprotective effects of losartan/thiazide combination therapy in terms of lowering the estimated glomerular filtration rate (eGFR).
  
  
  METHODS
  Adult patients with angiotensin receptor blocker (ARB)-resistant essential hypertension (n = 104) were enrolled and switched to combination therapy with losartan (50 mg/day) and hydrochlorothiazide (12.5 mg/day).
  
  
  RESULTS
  eGFR values declined significantly during the first 3 months, and changes in eGFR were assessed according to tertiles of the eGFR decrease ratio at 3 months. Only the high eGFR decrease (1st tertile) group showed significantly greater decreases in baseline eGFR and albumin-to-creatinine ratio (ACR) during the first 3 months. Additionally, the assessment according to tertiles of the baseline eGFR showed a signifcant decrease in eGFR and ACR during the first 3 months in the high baseline eGFR (1st tertile) group, but not in the moderate (2nd tertile) and low baseline eGFR (3rd tertile) groups.
  
  
  CONCLUSIONS
  The present results revealed that losartan/thiazide combination therapy attenuated glomerular overload, indicating that this therapy may provide glomerular protection in patients with an elevated GFR without causing prolonged damage to renal function.
authors.affiliation: Study Group of the Saitama Anti-hypertension Losartan-hydrochlorothiazide Trial (SALT), Saitama Medical University, Saitama 350-8550 (Japan).
authors.forename: Hajime
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Tayama
authors.forename: Kaori
authors.initials: K
authors.lastname: Takayanagi
authors.forename: Juko
authors.initials: J
authors.lastname: Asakura
authors.forename: Toru
authors.initials: T
authors.lastname: Nakamura
authors.forename: Kenji
authors.initials: K
authors.lastname: Kawashima
authors.forename: Taisuke
authors.initials: T
authors.lastname: Shimizu
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Iwashita
authors.forename: Tomonari
authors.initials: T
authors.lastname: Ogawa
authors.forename: Akihiko
authors.initials: A
authors.lastname: Matsuda
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mitarai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D000075222:Essential Hypertension; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects* / Q000502:physiology*; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage*; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology*; D007678:Kidney Glomerulus / Q000187:drug effects / Q000503:physiopathology; D019808:Losartan / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D004338:Drug Combinations; C505809:hydrochlorothiazide, losartan drug combination; D006852:Hydrochlorothiazide; D019808:Losartan