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document
Effects of telmisartan and enalapril on renoprotection in patients with mild to moderate chronic kidney disease . BACKGROUND Blocking the renin-angiotensin system ( RAS ) with angiotensin receptor blockers or angiotensin-converting enzyme inhibitors protects against renal injury in patients with chronic kidney disease ( CKD ) . The aim of this study was to compare the chronic effects of telmisartan and enalapril on proteinuria , urinary liver-type fatty acid-binding protein ( L-FABP ) and endothelin ( ET ) -1 levels in patients with mild CKD . MATERIALS AND METHODS Thirty CKD patients with mild to moderate renal insufficiency ( 20 men and 10 women ; mean age , 37 years ; estimated glomerular filtration rate ( eGFR ) > 60 mL min ( -1 ) and blood pressure > 130/85 mmHg ) were included in the study . Patients were randomly assigned to receive telmisartan at 80 mg day ( -1 ) ( n = 15 ) or enalapril at 10 mg day ( -1 ) ( n = 15 ) . We measured blood pressure , serum creatinine , eGFR , urinary protein , L-FABP and ET-1 before the start of treatment and 6 and 12 months after the start of treatment . RESULTS The blood pressure reduction rate was similar between the two groups . Urinary protein , L-FABP and ET-1 levels were significantly reduced in both groups 6 and 12 months ( P < 0.001 ) after treatment , but the reduction rates were more pronounced in patients receiving telmisartan than in those receiving enalapril ( P < 0.001 ) . Estimated glomerular filtration rate was increased similarly in both groups at 12 months . CONCLUSIONS The study results suggest that telmisartan results in a greater reduction of urinary markers than does enalapril and that this effect occurs by a mechanism independent of blood pressure reduction . It would be needed to investigate whether the differences may be distinct or not the same when other dosages are used .
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Intervention_Pharmacological
telmisartan
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Intervention_Pharmacological
enalapril
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Intervention_Pharmacological
telmisartan
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Intervention_Pharmacological
enalapril
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Intervention_Pharmacological
telmisartan at 80 mg day ( -1 )
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Intervention_Pharmacological
enalapril at 10 mg day ( -1 )
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Intervention_Pharmacological
telmisartan
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Intervention_Pharmacological
enalapril
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Intervention_Pharmacological
telmisartan
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Intervention_Pharmacological
enalapril
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Outcome_Other
Effects
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Outcome_Physical
urinary liver-type fatty acid-binding protein ( L-FABP )
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Outcome_Physical
endothelin ( ET ) -1 levels
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Outcome_Physical
estimated glomerular filtration rate ( eGFR )
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Outcome_Physical
blood pressure
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Outcome_Physical
serum creatinine , eGFR
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Outcome_Physical
urinary protein
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Outcome_Physical
L-FABP
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Outcome_Physical
ET-1
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Outcome_Physical
blood pressure reduction rate
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Outcome_Physical
Urinary protein
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Outcome_Physical
L-FABP
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Outcome_Physical
ET-1 levels
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Outcome_Physical
reduction rates
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Outcome_Physical
glomerular filtration rate
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Outcome_Physical
urinary markers
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Participant_Condition
mild to moderate chronic kidney disease
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Participant_Condition
chronic kidney disease ( CKD ) .
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Participant_Condition
mild CKD
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Participant_Condition
Thirty CKD patients
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Participant_Condition
mild to moderate renal insufficiency
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Participant_Sex
20 men and 10 women
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Participant_Age
37 years ; estimated glomerular filtration rate ( eGFR ) > 60 mL min ( -1 ) and blood pressure > 130/85 mmHg ) were included in the study .