TITLE:
Antiproteinuric Effect of Aliskiren versus Losartan in Primary Glomerulonephritis
AUTHORS:
Abdul Halim Abdul Gafor, Azrini Abdul Aziz, Rozita Mohd, Rizna Abdul Cader, Kong Wei Yen, Shamsul Azhar Shah, Norella C. T. Kong
KEYWORDS:
Primary Glomerulonephritis, Hypertension, Proteinuria, Aliskiren, Losartan
JOURNAL NAME:
Open Journal of Nephrology,
Vol.4 No.2,
May
22,
2014
ABSTRACT: Introduction:
Treatment with renin-angiotensin-aldosterone-system (RAAS) blockers plays a major
role in halting chonic kidney disease (CKD) progression. Aliskiren is the first
orally available direct renin inhibitor (DRI). Objective: We studied the
efficacy of aliskiren compared to losartan in patients with primary GN. Design
and Method: This was a prospective open-label randomized control trial in
patients with primary GN. Patients were randomized to receive either aliskiren
or losartan to maximum tolerated doses for 24 weeks. Blood and urine
investigations were measured at baseline and at 4-weekly intervals. Adverse
effects were recorded. Results: 22 patients were recruited (aliskiren-11 and
losartan-11). Their baseline characteristics were comparable with the exception
of a higher proteinuria (uPCI) in the aliskiren arm. There were no significant
differences in proteinuria, blood pressure and other renal parameters between
both groups. At end-study, only patients in the aliskiren arm showed
significant reductions in both the systolic blood pressure and in proteinuria.
There were no changes in the other parameters of renal function over time and
no adverse events occurred. Conclusion: Aliskiren appears to be as efficacious
and tolerable as losartan both as an antihypertensive and antiproteinuric
agent in this study.