Stronger Effect of Azilsartan on Reduction of Proteinuria Compared to Candesartan in Patients with CKD: A Randomized Crossover Trial.
Kidney Blood Press Res
; 46(2): 173-184, 2021.
Article
in En
| MEDLINE
| ID: mdl-33677450
ABSTRACT
INTRODUCTION:
Angiotensin receptor blockers (ARBs) are preferably used in hypertensive patients with CKD. Azilsartan is a strong antihypertensive ARB, but its antiproteinuric effects are not well understood. We compared the antiproteinuric effect of azilsartan and candesartan in CKD patients in an open-label, randomized, crossover trial.METHODS:
A total of 111 patients were treated with 20 mg of azilsartan daily for 2 months as a run-in period. After the run-in period, patients were randomized into 2 arms and received either 20 mg of azilsartan or 8 mg of candesartan daily for 3 months in a crossover trial. The primary outcome was the percent change in urinary protein-to-Cr ratio (UPCR).RESULTS:
Ninety-five patients completed the trial. The mean age was 64.3 years. The estimated glomerular filtration rate (eGFR) and UPCR were 41.5 mL/min/1.73 m2 and 1.8 g/gCr, respectively. The baseline systolic and diastolic blood pressures were 131.4 and 71.0 mm Hg, respectively. The mean percent change in the UPCR was -3.8% in the azilsartan group and 30.8% in the candesartan group at the 1st endpoint (p = 0.0004), and 6.1% in the azilsartan group and 25.8% in the candesartan group at the 2nd (final) endpoint (p = 0.029). The incidence of adverse events, including eGFR levels and serum potassium levels, was not significantly different between the groups.CONCLUSION:
A 20 mg azilsartan dose had potent antiproteinuric effects compared with an 8 mg candesartan dose, without an increase in adverse events. Azilsartan may provide renal protection in addition to antihypertensive effects in CKD patients.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Oxadiazoles
/
Proteinuria
/
Tetrazoles
/
Benzimidazoles
/
Biphenyl Compounds
/
Antineoplastic Combined Chemotherapy Protocols
/
Angiotensin II Type 1 Receptor Blockers
/
Renal Insufficiency, Chronic
Type of study:
Clinical_trials
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Kidney Blood Press Res
Journal subject:
NEFROLOGIA
Year:
2021
Type:
Article
Affiliation country:
Japan