Safety and tolerability of high-dose angiotensin receptor blocker therapy in patients with chronic kidney disease: A pilot study

American Journal of Nephrology

Volumn 24, Issue 3, 2004, Pages 340-345

  Weinberg, Adam J ^a,b   Zappe, Dion H ^b   Ashtonc, Michael ^c   Weinberg, Marc S ^d  

^a Boston University   (United States)

^b Hypertension and Nephrology Inc   (United States)

^c UNIVERSITY OF GOTHENBURG   (Sweden)

^d BOSTON UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

Angiotensin receptor blockers; Candesartan; Chronic renal disease; Diabetic renal disease; Non diabetic renal disease; Renoprotection; Supramaximal doses

Indexed keywords

ANGIOTENSIN RECEPTOR ANTAGONIST; CANDESARTAN HEXETIL; CREATININE; POTASSIUM;

ADULT; AGED; ARTICLE; BLOOD PRESSURE; CELLULITIS; CLINICAL ARTICLE; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; CREATININE BLOOD LEVEL; DIABETES MELLITUS; DOSE RESPONSE; DRUG SAFETY; DRUG TOLERABILITY; EPISTAXIS; FEMALE; FOOD AND DRUG ADMINISTRATION; HEART ATRIUM ARRHYTHMIA; HUMAN; KIDNEY DISEASE; KIDNEY FUNCTION; LEG CRAMP; MALE; MAXIMUM PERMISSIBLE DOSE; OPEN STUDY; PERIPHERAL EDEMA; PILOT STUDY; POTASSIUM BLOOD LEVEL; PRIORITY JOURNAL; PROTEINURIA; SIDE EFFECT; SYNCOPE; TABLET; TITRIMETRY; TREMOR;

ADULT; AGED; AGED, 80 AND OVER; ANGIOTENSIN II TYPE 1 RECEPTOR BLOCKERS; BENZIMIDAZOLES; CHRONIC DISEASE; FEMALE; HUMANS; KIDNEY DISEASES; MALE; MIDDLE AGED; TETRAZOLES;

EID: 4043101107     PISSN: 02508095     EISSN: None     Source Type: Journal    
DOI: 10.1159/000078950     Document Type: Article

References (24)

1. Weir MR: Progressive renal and cardiovascular disease: Optimal treatment strategies. Kidney Int 2002;62:1482-1492.
2. De Jong PE, D de Zeeuw, G Navis: Renoprotective therapy: Titration against urinary protein excretion. Lancet 1999;354:352-353.
3. Gansevoort RT, Sluiter WJ, Hemmelder H, et al: Antiproteinuric effect of blood-pressure-lowering agents: A meta-analysis of comparative trials. Nephrol Dial Transplant 1995;10:1963-1974.
4. Ruggenenti P, Schieppati A, Remuzzi G: Progression, remission, regression of chronic renal disease. Lancet 2001;357:1601-1608.
5. Remuzzi G: Nephropathic nature of proteinuria. Curr Opin Nephrol Hypertens 1999;8:655-663.
6. Navis G, Kramer AB, de Jong PE: High-dose ACE inhibition: Can it improve renoprotection? Am J Kidney Dis 2002;40:664-666.
7. Weinberg MS, Weinberg AJ, Zappe DH: Effectively targetting the renin-angiotensin-aldosterone system in cardiovascular and renal disease: Rationale for using angiotensin II receptor blockers in combination with angiotensinconverting enzyme inhibitors. J Renin Angiotensin Aldosterone Syst 2000;1:217-233.
8. Weinberg MS, Kaperonis N, Bakris GL: How high should an ACE inhibitor or angiotensin receptor blocker be dosed in patients with diabetic nephropathy? Curr Hypertens Rep 2003;5:418-425.
9. Rossing K, Jacobsen P, Pietraszek L, Parving H-H: Renoprotective effects of adding angiotensin II receptor blocker to maximal recommended doses of ACE inhibitor in diabetic nephropathy: A randomized double-blind crossover trial. Diabetes Care 2003;26:2268-2274.
10. Weir MR: Are drugs that block the renin-angiotensin system effective and safe in patients with renal insufficiency? Am J Hypertens 1999;12:195S-203S.
11. Weinberg MS, Weinberg AJ, Cord R, Zappe DH: The effect of high dose angiotensin II receptor blockade beyond maximal recommended doses in reducing urinary protein excretion. J Renin Angiotensin Aldosterone Syst 2001;2(suppl 1):S196-S198.
12. Stenhoff H, Lagerstrom PO, Andersen C: Determination of candesartan cilexetil, candesartan and a metabolite in human plasma and urine by liquid chromatography and fluorometric detection. J Chromatogr B Biomed Sci Appl 1999;731:411-417.
13. Jafar TH, Schmid CH, Landa M, et al: Angiotensin-converting enzyme inhibitors and progression of nondiabetic renal disease. A meta-analysis of patient-level data. Ann Intern Med 2001;135:73-87.
14. Parving HH, Lehnert H, Bröchner-Mortensen J et al for the Irbesartan in Patients with Type 2 Diabetes and Microalbuminuria Study Group: The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med 2001;345:870-878.
15. Laverman GD, Navis G, Henning RH, et al: Dual renin-angiotensin system blockade at optimal doses for proteinuria. Kidney Int 2002;62:1020-1025.
16. Rossing K, Christensen PK, Hansen BV, et al: Optimal dose of candesartan for renoprotection in type 2 diabetic patients with nephropathy: A double-blind randomized cross-over study. Diabetes Care 2003;26:150-155.
17. Benz J, Oshrain C, Henry D, et al: Valsartan, a new angiotensin II receptor antagonist: A double-blind study comparing the incidence of cough with lisinopril and hydrochlorothiazide. J Clin Pharmacol 1997;37:101-107.
18. De Zeeuw D, Remuzzi G, Kirch W: Pharmacokinetics of candesartan cilexetil in patients with renal or hepatic impairment. J Hum Hypertens 1997;11(suppl 2):37-42.
19. Morsing P, Adler G, Brandt-Eliasson U, et al: Mechanistic differences of various AT1-receptor blockers in isolated vessels of different origin. Hypertension 1999;33:1406-1413.
20. 14C-candesartan cilexetil in healthy volunteers. J Hum Hypertens 1997;11(suppl 2):27-28.
21. Shiigai T, Shichiri M: Late escape from the antiproteinuric effect of ACE inhibitors in non-diabetic renal disease. Am J Kidney Dis 2001;37:477-483.
22. Lewis EJ, Hunsicker LB, Clarke WR, et al: Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 2001;345:851-860.
23. Brenner BM, Cooper ME, de Zeeuw D, et al: Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med 2001;345:861-869.
24. Forclaz A, Maillard M, Nussberger J, et al: Angiotensin II receptor blockade: Is there truly a benefit of adding an ACE inhibitor? Hypertension 2003;41:31-36.