BACKGROUND: The major cause of hereditary renal failure is autosomal dominant polycystic kidney disease (ADPKD). Many factors affect renal progression in these patients. Among these, hypertension and an increase in renal volume are interrelated in terms of their effects on renal progression. We aimed to investigate the effects of losartan and ramipril on renal volume and progression in patients with ADPKD. MATERIALS AND METHODS: Data from 18 hypertensive patients with ADPKD were evaluated. Eleven of the 18 hypertensive patients were on losartan and 7 on ramipril treatment. Demographic parameters, use of antihypertensives and other medications, the course of blood pressure (BP), biochemical parameters, creatinine clearance (CrCL), findings at computed tomography and renal volume were recorded at baseline and at 1 and 5 years. RESULTS: Target BP values were maintained over 5 years. The annual decrease in CrCL was 1.33 mL/min in the losartan group compared with 6.59 mL/min in the ramipril group. There was no significant difference between the groups in terms of annual decrease in CrCL. Annual increase in renal volume was 252.04 cm³ in the losartan group and 167.36 cm³ in the ramipril group. There was no significant difference between the groups in terms of the increase in renal volumes at 1 and 5 years. CONCLUSION: Our study demonstrated that losartan and ramipril provided effective BP control. In addition, the results of our study demonstrated that despite the increase in renal volume, losartan and ramipril may have regressed renal progression via other factors.
BACKGROUND: The major cause of hereditary renal failure is autosomal dominant polycystic kidney disease (ADPKD). Many factors affect renal progression in these patients. Among these, hypertension and an increase in renal volume are interrelated in terms of their effects on renal progression. We aimed to investigate the effects of losartan and ramipril on renal volume and progression in patients with ADPKD. MATERIALS AND METHODS: Data from 18 hypertensivepatients with ADPKD were evaluated. Eleven of the 18 hypertensivepatients were on losartan and 7 on ramipril treatment. Demographic parameters, use of antihypertensives and other medications, the course of blood pressure (BP), biochemical parameters, creatinine clearance (CrCL), findings at computed tomography and renal volume were recorded at baseline and at 1 and 5 years. RESULTS: Target BP values were maintained over 5 years. The annual decrease in CrCL was 1.33 mL/min in the losartan group compared with 6.59 mL/min in the ramipril group. There was no significant difference between the groups in terms of annual decrease in CrCL. Annual increase in renal volume was 252.04 cm³ in the losartan group and 167.36 cm³ in the ramipril group. There was no significant difference between the groups in terms of the increase in renal volumes at 1 and 5 years. CONCLUSION: Our study demonstrated that losartan and ramipril provided effective BP control. In addition, the results of our study demonstrated that despite the increase in renal volume, losartan and ramipril may have regressed renal progression via other factors.
Authors: Andreas L Serra; Diane Poster; Andreas D Kistler; Fabienne Krauer; Shagun Raina; James Young; Katharina M Rentsch; Katharina S Spanaus; Oliver Senn; Paulus Kristanto; Hans Scheffel; Dominik Weishaupt; Rudolf P Wüthrich Journal: N Engl J Med Date: 2010-06-26 Impact factor: 91.245
Authors: C Sise; M Kusaka; L H Wetzel; F Winklhofer; B D Cowley; L T Cook; M Gordon; J J Grantham Journal: Kidney Int Date: 2000-12 Impact factor: 10.612
Authors: N Hateboer; M A v Dijk; N Bogdanova; E Coto; A K Saggar-Malik; J L San Millan; R Torra; M Breuning; D Ravine Journal: Lancet Date: 1999-01-09 Impact factor: 79.321
Authors: Diane Poster; Andreas D Kistler; Fabienne Krauer; Jon D Blumenfeld; Hanna Rennert; Dominik Weishaupt; Rudolf P Wüthrich; Andreas L Serra Journal: Am J Kidney Dis Date: 2009-06-10 Impact factor: 8.860