title: Aliskiren in an alternate-day administration schedule in hypertensive albuminuric patients.
abstract: OBJECTIVE
  It has been suggested that aliskiren has a long half-life and maintains a blood pressure (BP)-lowering effect following a missed dose. We tested the hypothesis that every other day (eod) administration of aliskiren has the same effects as the once daily (od) dosing in albuminuric hypertensive patients.
  
  
  METHODS
  Fifteen hypertensive patients, after a 4-week wash-out period on clonidine, received 300 mg aliskiren od as the sole treatment. In patients who remained out of target, other nonrenin-angiotensin system blockers were added. Patients who completed a 24-week (w24) treatment period were switched to eod administration of aliskiren for an additional period of 24 weeks (w48).
  
  
  RESULTS
  Thirteen patients completed the full study protocol. The mean office BP was reduced at the end of w24 (-9/3 mmHg), a reduction that continued to be observed at w48 (-11/1 mmHg). At the end of the study, the 48 h ambulatory BP monitoring was divided into two 24 h periods. The mean 24 h systolic BP, and the mean daytime systolic and diastolic BP were significantly lower (P<0.05) in the first 24 h (when aliskiren was taken) compared with the second period. Central hemodynamics showed no significant differences at any time during monitoring. Administration of aliskiren resulted in a median reduction of urine albumin/creatinine ratio of 103 mg/g (od) and 102 mg/g (eod). Differences in plasma renin activity, plasma renin concentration, and aldosterone-level measurements were not significant.
  
  
  CONCLUSIONS
  The BP-lowering effect of eod aliskiren administration, although adequate, is less efficient compared with od administration, despite the fact that in terms of reducing albuminuria, it appears to be effective.
authors.affiliation: Department of Nephrology, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Spanos
authors.forename: Rigas G
authors.initials: RG
authors.lastname: Kalaitzidis
authors.forename: Despina P
authors.initials: DP
authors.lastname: Karasavvidou
authors.forename: Xanthi
authors.initials: X
authors.lastname: Zikou
authors.forename: Kostas C
authors.initials: KC
authors.lastname: Siamopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology / Q000652:urine; D000577:Amides / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects*; D003404:Creatinine / Q000652:urine; D005260:Female; D005650:Fumarates / Q000008:administration & dosage*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology / Q000652:urine; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012083:Renin / Q000097:blood; D013997:Time Factors
chemical_list: D000577:Amides; D000959:Antihypertensive Agents; D005650:Fumarates; C446481:aliskiren; D003404:Creatinine; D012083:Renin