Long-term effects of aliskiren on blood pressure and the renin-angiotensin-aldosterone system in hypertensive hemodialysis patients

Abstract

Yoshiyuki Morishita1, Minami Watanabe1, Shiho Hanawa1, Osamu Iimura2, Sadao Tsunematsu3, Kenichi Ishibashi4, Eiji Kusano11Division of Nephrology, Department of Medicine, Jichi Medical University, Tochigi, Japan; 2Kumakura Clinic, Tochigi, Japan; 3Yuki Clinic, Ibaragi, Japan; 4Department of Medical Physiology, Meiji Pharmaceutical University, Tokyo, JapanObjective: The long-term effects of aliskiren in hypertensive hemodialysis patients remain to be elucidated.Design: In this post hoc analysis, we followed up 25 hypertensive hemodialysis patients who completed 8-week aliskiren treatment in a previous study for 20 months to investigate the blood pressure-lowering effect and inhibitory effect on the renin-angiotensin-aldosterone system.Results: Among the 25 patients, eleven patients continued with aliskiren treatment. Blood pressure (± standard deviation) decreased from 175 ± 18/80 ± 11 mmHg at baseline to 156 ± 20/76 ± 9 mmHg at month 20. Plasma renin activity, angiotensin I, and angiotensin II decreased from baseline to month 20 (plasma renin activity (ng/mL/h): 2.3 ± 2.6 to 0.3 ± 0.4 (P < 0.05), angiotensin I (pg/mL): 909.1 ± 902.5 to 41.5 ± 14.8 (P < 0.05), angiotensin II (pg/mL): 41.5 ± 45.8 to 11.0 ± 4.9 (P < 0.05).Conclusion: Long-term treatment with aliskiren provides effective blood pressure lowering and inhibition of the renin-angiotensin-aldosterone system, which are sustained over 20 months in hypertensive hemodialysis patients.Keywords: aliskiren, blood pressure, renin, angiotensin, aldosterone, hemodialysis patients, long-term effects