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2017 | 64 | 2 | 221-226
Article title

Aliskiren reduces albuminuria after kidney transplantation

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EN
Abstracts
EN
Background: The renoprotective effects of the direct renin inhibitor, aliskiren, in renal transplant recipients have been supposed, but not finally proven. We performed an exploratory double-blind, losartan controlled, cross-over study to evaluate the influence of aliskiren, direct renin inhibitor, on albuminuria and other surrogate markers of kidney injury in patients after renal transplantation. The safety of this therapy was also evaluated. Method: 16 of 18 patients (12 M, 4 F), 48.3 ± 9.0 years, 57.7 ± 9.1 months after kidney transplantation, with hypertension and stable serum creatinine 1.4 ± 0.08 mg/dl without proteinuria, completed the protocol. Each patient underwent two 8-week treatment periods (one with 150 mg of aliskiren, and one with 50 mg of losartan) in random order, allowing an 8-week placebo washout between them. Results: There were no differences in albuminuria, transforming growth factor β-1 and 15-F2t-isoprostanes urine excretion between aliskiren and losartan. Creatinine serum level, eGFR, 24 h systolic and 24 h diastolic blood pressure were stable through the study. There were no differences in haemoglobin and potassium serum concentration between studied drugs. Conclusion: Aliskiren decreases albuminuria in renal transplant recipients with clinically minimal side effects. The effect does not differ from that of losartan.
Publisher

Year
Volume
64
Issue
2
Pages
221-226
Physical description
Dates
published
2017
received
2016-03-29
revised
2016-11-21
accepted
2017-01-08
(unknown)
2017-04-28
Contributors
  • Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
  • Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
  • Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
  • Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
  • Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
author
  • Department of Occupational and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
  • Department of General Nursery, Medical University of Gdansk, Gdańsk, Poland
  • Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
  • Department of General Nursery, Medical University of Gdansk, Gdańsk, Poland
  • Department of Clinical Nutrition, Medical University of Gdansk, Gdańsk, Poland
  • Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
References
  • Al-Harbi NO, Imam F, Al-Harbi MM, Iqbal M, Nadeem A, Al-Shahrah OA, Korashy HM, Al-Hosaini KA, Ahmed M, Bahashwar S (2014) Treatment with aliskiren ameliorates tacrolimus-induced nephrotoxicity in rats. J Renin Angiotensin Aldosterone Syst. doi: 10.1177/1470320314530178.
  • Bailie GR, Uhlig K, Levey AS (2005) Clinical practice guidelines in nephrology: evaluation, classification, and stratification of chronic kidney disease. Pharmacotherapy 25: 491-502.
  • Djamali A, and Samaniego M (2009) Fibrogenesis in kidney transplantation: potential targets for prevention and therapy. Transplantation 88: 1149-1156. doi: 10.1097/TP.0b013e3181bcccea.
  • Fernandez-Fresnedo G, Escallada R, Rodrigo E, De Francisco AL, Cotorruelo JG, Sanz De Castro S, Zubimendi JA, Ruiz JC, Arias M (2002) The risk of cardiovascular disease associated with proteinuria in renal transplant patients. Transplantation 73: 1345-1348.
  • Fernandez-Fresnedo G, Plaza JJ, Sanchez-Plumed J, Sanz-Guajardo A, Palomar-Fontanet R, Arias M (2004) Proteinuria: a new marker of long-term graft and patient survival in kidney transplantation. Nephrol Dial Transplant 19: iii47-iii51.
  • Gansevoort R, De Zeeuw D, De Jong P (1994) Is the antiproteinuric effect of ACE inhibition mediated by interference in the renin-angiotensin system? Kidney Int 45: 861-867.
  • Heinze G, Mitterbauer C, Regele H, Kramar R, Winkelmayer WC, Curhan GC, Oberbauer R (2006) Angiotensin-converting enzyme inhibitor or angiotensin II type 1 receptor antagonist therapy is associated with prolonged patient and graft survival after renal transplantation. J Am Soc Nephrol 17: 889-899. doi: 10.1681/ASN.2005090955.
  • Ibrahim HN, Jackson S, Connaire J, Matas A, Ney A, Najafian B, West A, Lentsch N, Ericksen J, Bodner J, Kasiske B, Mauer M (2014) Angiotensin II blockade in kidney transplant recipients. J Am Soc Nephrol 24: 320-327. doi: 10.1681/ASN.2012080777.
  • Komenda P, Rigatto C, Tangri N (2014) Estimated glomerular filtration rate and albuminuria: diagnosis, staging, and prognosis. Curr Opin Nephrol Hypertens 23: 251-257. doi: 10.1097/01.mnh.0000444910.55665.e8.
  • Liu Y, Chen K, Kou X, Han Y, Zhou L, Zeng C (2013) Aliskiren and amlodipine in the management of essential hypertension: meta-analysis of randomized controlled trials. PLoS One 8: e70111. doi: 10.1371/journal.pone.0070111.
  • Lizakowski S, Tylicki L, Renke M, Rutkowski P, Heleniak Z, Slawinska-Morawska M, Aleksandrowicz E, Lysiak-Szydlowska W, Rutkowski B (2013a) Effect of aliskiren on proteinuria in non-diabetic chronic kidney disease: a double-blind, crossover, randomised, controlled trial. Int Urol Nephrol 44: 1763-1770.
  • Lizakowski S, Tylicki L, Rutkowski B (2013b) Direct renin inhibition - a promising strategy for renal protection? Med Sci Monit 19: 451–457. doi: 10.12659/MSM.883949.
  • Opelz G, Dohler B (2014) Cardiovascular death in kidney recipients treated with renin-angiotensin system blockers. Transplantation 97: 310-315. doi: 10.1097/01.TP.0000437672.78716.28.
  • Opelz G, Zeier M, Laux G, Morath C, Dohler B (2006) No improvement of patient or graft survival in transplant recipients treated with angiotensin-converting enzyme inhibitors or angiotensin II type 1 receptor blockers: a collaborative transplant study report. J Am Soc Nephrol 17: 3257-3262. doi: 10.1681/ASN.2006050543.
  • Parving HH, Brenner BM, McMurray JJ, de Zeeuw D, Haffner SM, Solomon SD, Chaturvedi N, Persson F, Desai AS, Nicolaides M, Richard A, Xiang Z, Brunel P, Pfeffer MA (2012) Cardiorenal end points in a trial of aliskiren for type 2 diabetes. N Engl J Med 367: 2204-2213. doi: 10.1056/NEJMoa1208799.
  • Paul LC (1999) Chronic allograft nephropathy: An update. Kidney International 56: 783-793.
  • Persson F, Rossing P, Reinhard H, Juhl T, Stehouwer CD, Schalkwijk C, Danser AH, Boomsma F, Frandsen E, Parving HH (2009) Renal effects of aliskiren compared with and in combination with irbesartan in patients with type 2 diabetes, hypertension, and albuminuria. Diabetes Care 32: 1873-1879. doi: 10.2337/dc09-0168.
  • Philipp T, Martinez F, Geiger H, Moulin B, Mourad G, Schmieder R, Lievre M, Heemann U, Legendre C (2010) Candesartan improves blood pressure control and reduces proteinuria in renal transplant recipients: results from SECRET. Nephrol Dial Transplant 25: 967-976. doi: 10.1093/ndt/gfp581.
  • Price R (1982) Urinary enzymes, nephrotoxicity and renal disease. Toxicology 23: 99-134.
  • Renke M, Knap N, Tylicki L, Rutkowski P, Lizakowski S, Wozniak M, Rutkowski B (2013) Isoprostanes - important marker of the oxidative stress estimation in patients with chronic kidney disease. Pol Merkur Lekarski 34: 14–17 (in Polish).
  • Roberts MA (2014) Commentary on the KDIGO Clinical Practice Guideline for the management of blood pressure in chronic kidney disease. Nephrology (Carlton) 19: 53-55. doi: 10.1111/nep.12168.
  • Rusai K, Schmaderer C, Hermans JJ, Lutz J, Heemann U, Baumann M (2011) Direct renin inhibition in a rat model of chronic allograft injury. Transplantation 92: 999-1004. doi: 10.1097/TP.0b013e318230c05b.
  • Sharma VK, Bologa RM, Xu GP, Li B, Mouradian J, Wang J, Serur D, Rao V, Suthanthiran M (1996) Intragraft TGF-beta 1 mRNA: a correlate of interstitial fibrosis and chronic allograft nephropathy. Kidney Int 49: 1297-1303.
  • Sherman R, Drayer D, Leyland-Jones B, Reidenberg M (1983) N-acetyl-beta-glucosaminidase and beta 2-microglobulin. Their urinary excretion in patients with renal parenchymal disease. Arch Intern Med 143: 1183-1185.
  • Solez K, Vincenti F, Filo RS (1998) Histopathologic findings from 2-year protocol biopsies from a U.S. multicenter kidney transplant trial comparing tarolimus versus cyclosporine: a report of the FK506 Kidney Transplant Study Group. Transplantation 66: 1736-1740.
  • Szeto CC, Kwan BC, Chow KM, Leung CB, Li PK (2013) The safety and short-term efficacy of aliskiren in the treatment of immunoglobulin a nephropathy - a randomized cross-over study. PLoS One 8: e62736. doi: 10.1371/journal.pone.0062736.
  • Tylicki L, Biedunkiewicz B, Chamienia A, Wojnarowski K, Zdrojewski Z, Aleksandrowicz E, Lysiak-Szydlowska W, Rutkowski B (2007) Renal allograft protection with angiotensin II type 1 receptor antagonists. Am J Transplant 7: 243-248. doi: 10.1111/j.1600-6143.2006.01588.x.
  • Tylicki L, Biedunkiewicz B, Chamienia A, Wojnarowski K, Zdrojewski Z, Rutkowski B (2006) Randomized placebo-controlled study on the effects of losartan and carvedilol on albuminuria in renal transplant recipients. Transplantation 81: 52-56.
  • Tylicki L, Habicht A, Watschinger B, Horl W (2003) Treatment of hypertension in renal transplant recipients. Curr Opin Urol 13: 91-98. doi: 10.1097/01.mou.0000058634.64616.08.
  • Tylicki L, Larczynski W, Rutkowski B (2005) Renal protective effects of the renin-angiotensin-aldosterone system blockade: from evidence-based approach to perspectives. Kidney Blood Press Res 28: 230-242. doi: 10.1159/000087842.
Document Type
Publication order reference
Identifiers
YADDA identifier
bwmeta1.element.bwnjournal-article-abpv64p221kz
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