title: Effects of aliskiren on blood pressure and humoral factors in hypertensive hemodialysis patients previously on angiotensin II receptor antagonists.
abstract: BACKGROUND
  A direct renin inhibitor (DRI), aliskiren, may be effective for blood pressure (BP) control in hemodialysis patients. However, it is unclear whether aliskiren has a greater beneficial effect on BP and humoral factors than angiotensin II receptor antagonists (ARBs) in hypertensive patients on hemodialysis.
  
  
  METHODS
  Eighteen hemodialysis patients (58 ± 14 years) on the recommended dose of an ARB were prospectively randomized into two groups: ARB and DRI groups. Patients in the ARB group continued taking their previous ARB, whereas those in the DRI group switched to aliskiren (150 mg/day) for 12 weeks. Baseline measurements of BP and humoral factors such as plasma renin activity (PRA), plasma aldosterone concentration (PAC) and brain natriuretic peptide (BNP) were performed. Measurements were repeated every 4 weeks.
  
  
  RESULTS
  At baseline, no differences were observed in age, gender or BP between the two groups. Systolic BP was unaffected by treatment in either groups (group effect, p = 0.26; time effect, p = 0.38; group × time effect, p = 0.24). PRA decreased in DRI (p ≤ 0.02, group effect, p = 0.65; time effect, p = 0.13; group × time effect, p = 0.048), but not in ARB (p ≥ 0.94). PAC increased only in DRI (p ≤ 0.03), whereas BNP was unaffected in either group.
  
  
  CONCLUSIONS
  Aliskiren at a dose of 150 mg/day had a similar effect on BP compared with ARBs, but significantly lowered PRA.
authors.affiliation: Department of Internal Medicine, Kuwana East Medical Center , Kuwana, Mie , Japan .
authors.forename: Takayasu
authors.initials: T
authors.lastname: Ito
authors.forename: Eiji
authors.initials: E
authors.lastname: Ishikawa
authors.forename: Naoki
authors.initials: N
authors.lastname: Fujimoto
authors.forename: Setsuya
authors.initials: S
authors.lastname: Okubo
authors.forename: Goro
authors.initials: G
authors.lastname: Ito
authors.forename: Takehiko
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nomura
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
mesh_terms: D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood; D000577:Amides / Q000627:therapeutic use*; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D005650:Fumarates / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D006435:Renal Dialysis; D012083:Renin / Q000097:blood; D000092502:Renin Inhibitors
chemical_list: D000450:Aldosterone; D000577:Amides; D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D005650:Fumarates; D020097:Natriuretic Peptide, Brain; D012083:Renin; D000092502:Renin Inhibitors; C446481:aliskiren
keywords: Aliskiren; angiotensin II receptor antagonists; direct renin inhibitor; hemodialysis; hypertension