Release From Glomerular Overload by the Addition of Low-dose Thiazide in Patients With Angiotensin Receptor Blocker-Resistant Hypertension

• Main Authors: Hajime Hasegawa (Author), Yosuke Tayama (Author), Kaori Takayanagi (Author), Juko Asakura (Author), Toru Nakamura (Author), Kenji Kawashima (Author), Taisuke Shimizu (Author), Takatsugu Iwashita (Author), Tomonari Ogawa (Author), Akihiko Matsuda (Author), Tetsuya Mitarai (Author)
• Format: Book
• Published: Karger Publishers, 2013-11-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Background/Aims: This multicenter, prospective, observational study assessed the renoprotective effects of losartan/thiazide combination therapy in terms of lowering the estimated glomerular filtration rate (eGFR). Methods: Adult patients with angiotensin receptor blocker (ARB)-resistant essential hypertension (n = 104) were enrolled and switched to combination therapy with losartan (50 mg/day) and hydrochlorothiazide (12.5 mg/day). Results: eGFR values declined significantly during the first 3 months, and changes in eGFR were assessed according to tertiles of the eGFR decrease ratio at 3 months. Only the high eGFR decrease (1st tertile) group showed significantly greater decreases in baseline eGFR and albumin-to-creatinine ratio (ACR) during the first 3 months. Additionally, the assessment according to tertiles of the baseline eGFR showed a signifcant decrease in eGFR and ACR during the first 3 months in the high baseline eGFR (1st tertile) group, but not in the moderate (2nd tertile) and low baseline eGFR (3rd tertile) groups. Conclusion: The present results revealed that losartan/thiazide combination therapy attenuated glomerular overload, indicating that this therapy may provide glomerular protection in patients with an elevated GFR without causing prolonged damage to renal function.

Item Description

1420-4096
1423-0143
10.1159/000355732