title: Aliskiren attenuates oxidative stress and improves tubular status in non-diabetic patients with chronic kidney disease-Placebo controlled, randomized, cross-over study.
abstract: OBJECTIVE
  Pharmacological inhibition of the renin-angiotensin-aldosteron system (RAAS) may have a beneficial impact on proteinuria and chronic kidney diseases (CKD) progression. Despite recent progress by means of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB), there is still no optimal therapy which can stop progression of the nephropathy. Recently introduced aliskiren is the first orally bioavailable direct renin inhibitor approved for the treatment of hypertension. The purpose was to evaluate the extent of oxidative stress and tubular injury after the direct renin inhibitor, aliskiren compared with placebo and perindopril in patients with non-diabetic chronic kidney disease (NDCKD).
  
  
  METHODS
  A randomized, double-blind, cross-over trial was performed in 14 patients receiving 300mg aliskiren, 10mg perindopril and placebo in random order. The end point was a change in the urinary excretion of N-acetyl-β-D-glucosaminidase (NAG) and α1-microglobulin (α1m) and 15-F(2α)-isoprostane.
  
  
  RESULTS
  Aliskiren reduced excretion of 15-F(2α)-isoprostane (p=0.03) and α1m (p=0.01) as compared to placebo. There were no differences between aliskiren and perindopril in this regard. NAG urine excretion did not change after aliskiren and perindopril.
  
  
  CONCLUSIONS
  Aliskiren attenuates oxidative stress and may improve functional status of tubules in patients with NDCKD.
authors.affiliation: Department of Occupational and Internal Medicine, Medical University of Gdansk, Gdansk, Poland. Electronic address: mrenke@gumed.edu.pl.
authors.forename: Marcin
authors.initials: M
authors.lastname: Renke
authors.affiliation: Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Sławomir
authors.initials: S
authors.lastname: Lizakowski
authors.affiliation: Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Leszek
authors.initials: L
authors.lastname: Tylicki
authors.affiliation: Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Przemysław
authors.initials: P
authors.lastname: Rutkowski
authors.affiliation: Department of Medical Chemistry, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Narcyz
authors.initials: N
authors.lastname: Knap
authors.affiliation: Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Heleniak
authors.affiliation: Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Maja
authors.initials: M
authors.lastname: Sławińska-Morawska
authors.affiliation: Department of Clinical Nutrition and Laboratory Diagnostics, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Aleksandrowicz-Wrona
authors.affiliation: Department of Occupational and Internal Medicine, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Januszczyk
authors.affiliation: Department of Occupational and Internal Medicine, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Wójcik-Stasiak
authors.affiliation: Department of Clinical Nutrition and Laboratory Diagnostics, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Małgorzewicz
authors.affiliation: Department of Medical Chemistry, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Woźniak
authors.affiliation: Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Bolesław
authors.initials: B
authors.lastname: Rutkowski
mesh_terms: D000328:Adult; D000577:Amides / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005650:Fumarates / Q000627:therapeutic use*; D006801:Humans; D007684:Kidney Tubules / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D018384:Oxidative Stress / Q000187:drug effects*; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000503:physiopathology; D000092502:Renin Inhibitors
chemical_list: D000577:Amides; D000959:Antihypertensive Agents; D005650:Fumarates; D000092502:Renin Inhibitors; C446481:aliskiren
keywords: Aliskiren; Chronic kidney disease; Kidney; Oxidative stress; Tubular injury