摘要
AIM： To assess the effcacy of combined Aliskiren and Losartan vs high dose Losartan and Aliskiren alone in chronic kidney disease （CKD）.METHODS： This is a retrospective study of 143 pa-tients with non-diabetic CKD comparing combined Aliskiren （150 mg/d） with Losartan （100 mg/d） therapy vs High dose Angiotensin receptor blockers （ARB） （Losartan 200 mg/d） and the third group Aliskiren （150 mg/d） alone. This study involved only patient medi-cal records. Entry criteria included those patients who had been treated with the above drugs for at least 36 mo within the 5 years period; other criteria included proteinuria of 1 g or more and or CKD Stage 3 at the start of the 36 mo period. The study utilised primary renal end points of estimated Glomerular Filtration Rate （eGFR） 〈 15 mL/min or end stage renal failure. RESULTS： Patients treated with high dose ARB com-pared to the other two treatment groups had signifcantly less proteinuria at the end of 36 mo （ P 〈 0.007）. All 3 groups had signifcant reduction of proteinuria （ P 〈 0.043, P 〈 0.001）. Total urinary protein was signifcantly differ-ent between the 3 groups over the 3-year study period （ P = 0.008）, but not eGFR. The changes in eGFR from baseline to each year were not signifcantly different be-tween the 3 therapeutic groups （ P 〈 0.119）. There were no significant differences in the systolic and diastolic blood pressure between the 3 drug groups throughout the 3 years. The incidence of hyperkalemia （〉 5.5 mmol/L） was 14.2% （7/49） in the Combined Aliskiren and ARB group, 8.7% （4/46） in the Aliskiren alone group and 6.3% （3/48） in the High dose ARB group （ P 〈 0.001）.CONCLUSION： This study in non-diabetic CKD pa-tients showed that Combination therapy with Aliskiren and ARB was effective but was not safe as it was asso-ciated with a high prevalence of hyperkalaemia.
AIM: To assess the efficacy of combined Aliskiren and Losartan vs high dose Losartan and Aliskiren alone in chronic kidney disease(CKD).METHODS: This is a retrospective study of 143 patients with non-diabetic CKD comparing combined Aliskiren(150 mg/d) with Losartan(100 mg/d) therapyvs High dose Angiotensin receptor blockers(ARB)(Losartan 200 mg/d) and the third group Aliskiren(150 mg/d) alone. This study involved only patient medical records. Entry criteria included those patients who had been treated with the above drugs for at least 36 mo within the 5 years period; other criteria included proteinuria of 1 g or more and or CKD Stage 3 at the start of the 36 mo period. The study utilised primary renal end points of estimated Glomerular Filtration Rate(e GFR) < 15 m L/min or end stage renal failure. RESULTS: Patients treated with high dose ARB compared to the other two treatment groups had significantly less proteinuria at the end of 36 mo(P < 0.007). All 3 groups had significant reduction of proteinuria(P < 0.043, P < 0.001). Total urinary protein was significantly different between the 3 groups over the 3-year study period(P = 0.008), but not e GFR. The changes in e GFR from baseline to each year were not significantly different between the 3 therapeutic groups(P < 0.119). There were no significant differences in the systolic and diastolic blood pressure between the 3 drug groups throughout the 3 years. The incidence of hyperkalemia(> 5.5 mmol/L) was 14.2%(7/49) in the Combined Aliskiren and ARB group, 8.7%(4/46) in the Aliskiren alone group and 6.3%(3/48) in the High dose ARB group(P < 0.001). CONCLUSION: This study in non-diabetic CKD patients showed that Combination therapy with Aliskiren and ARB was effective but was not safe as it was associated with a high prevalence of hyperkalaemia.
基金
Supported by Singhealth Cluster with IRB approval,CIRB Ref:569E
