title: Examination of the effect of changing to azilsartan from candesartan in renal transplant patients.
abstract: BACKGROUND
  Azilsartan, an angiotensin receptor blocker (ARB), was administered to renal transplant recipients to investigate the safety and antihypertensive effect in addition to its ARB-characteristic organ-protective effect.
  
  
  METHODS
  The subjects were 20 patients (18 males, 2 females; baseline serum creatinine 2.39 ± 1.33 mg/dL) responding poorly to candesartan, who suffered albuminuria (>0.3 g/g creatinine) and hypertension (>140/90 mm Hg) following renal transplantation. Three months after candesartan was switched to azilsartan 20 mg/d, blood pressure, creatinine-corrected urinary albumin excretion, urinary L-type acid binding protein, urinary 8-hydroxydeoxyguano-sine, serum creatinine, and estimated glomerular filtration rate were evaluated. Thirteen patients received cyclosporine (65.0%) and 7 received tacrolimus (35.0%). Another hypertensive (calcium antagonist) agent was combined in 7 (35.0%).
  
  
  RESULTS
  Systolic blood pressure significantly decreased from 139.5 mm Hg (baseline) from 128.7 mm Hg (at 3 months), whereas no significant changes were observed for diastolic blood pressure. The percentage of patients achieving the target level of antihypertensive effect (blood pressure < 130/80 mm Hg) significantly improved from 30.0% (baseline) to 70.0% (at 3 months). No significant changes were observed in renal graft function, oxidative stress marker level, or biochemical examination findings.
  
  
  CONCLUSIONS
  Sufficient antihypertensive effect was demonstrated soon after switching to azilsartan. However, no significant change was found in renal damage markers. Long-term study must be conducted to confirm the protective effect azilsartan on the transplanted kidney, as found with candesartan. The safety of azilsartan was demonstrated. If the transplanted kidney protection is demonstrated, this drug is expected to contribute to the improved long-term prognosis of renal transplant recipients.
authors.affiliation: Department of Urology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan. Electronic address: hd-kinki@med.kindai.ac.jp.
authors.forename: T
authors.initials: T
authors.lastname: Ishii
authors.affiliation: Department of Urology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Yasuda
authors.affiliation: Department of Urology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Saito
authors.affiliation: Department of Urology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Mori
authors.affiliation: Department of Urology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Department of Urology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Uemura
authors.affiliation: Department of Urology, Sakai Hospital, Kinki University Faculty of Medicine, Sakai, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nose
authors.affiliation: Department of Urology, Sakai Hospital, Kinki University Faculty of Medicine, Sakai, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Nishioka
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D001713:Biphenyl Compounds; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D010069:Oxadiazoles / Q000627:therapeutic use*; D013777:Tetrazoles / Q000627:therapeutic use*
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D010069:Oxadiazoles; D013777:Tetrazoles; D003404:Creatinine; C521273:azilsartan; C081643:candesartan