Optimal dose of losartan for renoprotection in diabetic nephropathy
Optimal dose of losartan for renoprotection in diabetic nephropathy
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DOI：
10.1093/ndt/17.8.1413
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发表时间：
2002-08-01
影响因子：
6.1
通讯作者：
Parving, HH
中科院分区：
文献类型：
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作者：
Andersen, S;Rossing, P;Parving, HH
背景血管紧张素Ⅱ 1型受体拮抗剂是治疗糖尿病肾病的一类有价值的新药。本研究的目的是评估氯沙坦对糖尿病肾病肾保护和降压的最佳剂量。连续50例高血压1型糖尿病合并糖尿病肾病患者接受剂量递增的氯沙坦治疗，50、100和150 mg，每日1次，分3个阶段，每个阶段持续2个月。在基线和每个治疗期结束时，测定蛋白尿、24小时血压（TM 2420 A&D）和肾小球滤过率（GFR）（[Cr-51]EDTA血浆清除率）。白蛋白尿的基线值（几何平均值（95% CI））和GFR（平均值+/- SEM）分别为1138（904-1432）mg/24 h和91 +/- 3 ml/min/1.73 m2。基线血压为155/81 +/- 3/2 mmHg。所有剂量的氯沙坦都能降低蛋白尿和血压。洛沙坦50 mg、100 mg和150 mg组的白蛋白尿减少率分别为30%（95% CI（15-41））、48%（35-57）和44%（32-56）（所有P值
Background. Angiotensin II subtype-1 receptor antagonists represent a valuable new class of drugs in the treatment of diabetic nephropathy. The aim of our study was to evaluate the optimal dose of losartan for renoprotection and blood pressure reduction in diabetic nephropathy.Methods. Fifty consecutive hypertensive type 1 diabetic patients with diabetic nephropathy received increasing doses of losartan, 50, 100, and 150 mg once daily in three periods each lasting 2 months. At baseline and at the end of each treatment period, albuminuria, 24-h blood pressure (TM2420 A&D), and glomerular filtration rate (GFR) ([Cr-51]EDTA plasma clearance) were determined.Results. Baseline values of albuminuria (geometric mean (95% CI)) and GFR (means +/- SEM) were 1138 (904-1432) mg/24 h and 91 +/- 3 ml/min/1.73 m(2), respectively. The blood pressure at baseline was 155/81 +/- 3/2 mmHg. All doses of losartan reduced albuminuria and blood pressure. Albuminuria was reduced by 30% (95% CI (15-41)) on losartan 50 mg, 48% (35-57) by losartan 100 mg, and 44% (32-56) by losartan 150 mg (all P values