Aliskiren and losartan trial in non-diabetic chronic kidney disease

J Renin Angiotensin Aldosterone Syst. 2014 Dec;15(4):515-22. doi: 10.1177/1470320313510584. Epub 2014 Apr 17.

Abstract

Introduction: This is a report of a clinical trial on the therapeutic efficacy and safety of combined aliskiren and losartan (an angiotensin II receptor blocker (ARB)) versus aliskiren alone and ARB alone in non-diabetic chronic kidney disease (CKD) over a 3-year period.

Materials and methods: This was a randomised trial in 155 patients with non-diabetic CKD comparing aliskiren (150 mg/day) (n=52) versus losartan (100 mg/day) (n=52) and the third group aliskiren (150 mg/day) combined with losartan (100 mg/day) (n=51). The trial utilised primary renal end points of eGFR <15 ml/min or end-stage renal failure.

Results: All three groups had significant reduction of proteinuria (p<0.001 for all). The changes in eGFR, total urinary protein from baseline to each year were not significantly different between the three therapeutic groups.

Conclusion: This study in non-diabetic CKD patients showed that combination therapy with aliskiren and ARB was as efficacious as aliskiren alone and ARB alone. There was one patient who developed a non-fatal stroke in the combined aliskiren and ARB group while the other two groups had none.

Keywords: Aliskiren; chronic kidney disease; clinical trial; proteinuria; side effects.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amides / pharmacology
  • Amides / therapeutic use*
  • Blood Pressure / drug effects
  • Comorbidity
  • Demography
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Female
  • Fumarates / pharmacology
  • Fumarates / therapeutic use*
  • Glomerular Filtration Rate
  • Humans
  • Hyperkalemia / complications
  • Hyperkalemia / drug therapy
  • Hyperkalemia / physiopathology
  • Losartan / pharmacology
  • Losartan / therapeutic use*
  • Male
  • Middle Aged
  • Proteinuria / complications
  • Proteinuria / drug therapy
  • Proteinuria / physiopathology
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / drug therapy*
  • Renal Insufficiency, Chronic / physiopathology
  • Systole / drug effects

Substances

  • Amides
  • Fumarates
  • aliskiren
  • Losartan