Kidney & Blood Pressure Research (Nov 2013)

Release From Glomerular Overload by the Addition of Low-dose Thiazide in Patients With Angiotensin Receptor Blocker-Resistant Hypertension

  • Hajime Hasegawa,
  • Yosuke Tayama,
  • Kaori Takayanagi,
  • Juko Asakura,
  • Toru Nakamura,
  • Kenji Kawashima,
  • Taisuke Shimizu,
  • Takatsugu Iwashita,
  • Tomonari Ogawa,
  • Akihiko Matsuda,
  • Tetsuya Mitarai

DOI
https://doi.org/10.1159/000355732
Journal volume & issue
Vol. 37, no. 6
pp. 521 – 530

Abstract

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Background/Aims: This multicenter, prospective, observational study assessed the renoprotective effects of losartan/thiazide combination therapy in terms of lowering the estimated glomerular filtration rate (eGFR). Methods: Adult patients with angiotensin receptor blocker (ARB)-resistant essential hypertension (n = 104) were enrolled and switched to combination therapy with losartan (50 mg/day) and hydrochlorothiazide (12.5 mg/day). Results: eGFR values declined significantly during the first 3 months, and changes in eGFR were assessed according to tertiles of the eGFR decrease ratio at 3 months. Only the high eGFR decrease (1st tertile) group showed significantly greater decreases in baseline eGFR and albumin-to-creatinine ratio (ACR) during the first 3 months. Additionally, the assessment according to tertiles of the baseline eGFR showed a signifcant decrease in eGFR and ACR during the first 3 months in the high baseline eGFR (1st tertile) group, but not in the moderate (2nd tertile) and low baseline eGFR (3rd tertile) groups. Conclusion: The present results revealed that losartan/thiazide combination therapy attenuated glomerular overload, indicating that this therapy may provide glomerular protection in patients with an elevated GFR without causing prolonged damage to renal function.

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