Nephrology Dialysis Transplantation, Vol 13, Issue 12 3096-3102, Copyright © 1998 by Oxford University Press
H Holdaas, A Hartmann, K Berg, K Lund and P Fauchald
Background. The objective of this study was to examine
the effects of angiotensin II receptor blocker losartan
versus the calcium channel blocker amlodipine on
proteinuria, renal haemodynamics, glomerular sieving and tubular function
in hypertensive patients with non diabetic nephropathy. Methods.
The study design was a prospective, double blind, placebo
controlled, randomized crossover trial with amlodipine and losartan. Renal
parameters were measured at baseline and at the end of each 4-week active
treatment period. Fifteen patients with a diagnosis of non-diabetic renal
disease and hypertension were included. Results. Mean
arterial blood pressure decreased from 123±13 mmHg at baseline
to 113±10 mmHg (P<0.01) on losartan
and to 114±10 mmHg on amlodipine
(P<0.01). Urinary albumin excretion
significantly decreased from 3510±2586 mg/24 h at baseline to
2684±2051 mg/24 h (P<0.01) on
losartan and increased non-significantly to 3748±3355 mg/24 h on
amlodipine. Filtration fraction significantly decreased from a baseline
value of 22.8±9.3% to 21.2±10.2%
(P<0.05) on losartan and increased to
23.6±8.9 (ns) on amlodipine. Either drug did not significantly
alter glomerular sieving of neutral dextrans. Conclusion.
Our results demonstrate that losartan, but not amlodipine,
decreased albumin excretion in hypertensive patients with non-diabetic
nephropathy. Keywords: albuminuria; amlodipine;
glomerular sieving; losartan; non-diabetic disease
ORIGINAL ARTICLES
Renal effects of losartan and amlodipine in hypertensive patients with non-diabetic nephropathy
Department of Nephrology, Medical Department B, National Hospital, University of Oslo, 0027 Oslo, Norway; Corresponding author
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