A renoprotective effect of low dose losartan in patients with type 2 diabetes

• Published in: Diabetes research and clinical practice Vol. 79; no. 1; pp. 86 - 90
• Main Authors: Sawaki, Hideaki, Terasaki, Jungo, Fujita, Atsushi, Nakagawa, Seiko, Kanatsuna, Norio, Sadahiro, Katsuhiko, Isotani, Haruhiko, Imagawa, Akihisa, Hanafusa, Toshiaki
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.01.2008
• Subjects: Angiotensin II Type 1 Receptor Blockers - therapeutic use; Antihypertensive Agents - therapeutic use; Blood Pressure; Blood pressure at home; Body Mass Index; Diabetes Mellitus, Type 2 - complications; Diabetic Nephropathies - prevention & control; Endocrinology & Metabolism; Female; Humans; Lipids - blood; Losartan; Losartan - therapeutic use; Low dose ARB; Male; Middle Aged; Proteinuria - prevention & control; Renoprotective effect; Renoprotective effect; Losartan; Low dose ARB; Blood pressure at home
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2007.08.004

Abstract It has been reported that angiotensin II receptor blocker (ARB) improves proteinuria in diabetic patients. However, whether this is a direct effect of ARB or through lowering blood pressure is still controversial. The aim of this study is to determine the direct effect of ARB on diabetic nephropathy. Thirty-four type 2 diabetic patients with early kidney damage were divided into two groups: losartan group ( n = 17) and control group ( n = 17). In losartan group, low dose (25 mg) of losartan was administered once daily for a year. Blood pressure at home, blood pressure at office and urinary albumin/creatinine ratio (UACR) were measured before and during the treatment. After a 1-year observation, the increment of UACR was significantly smaller in losartan group than that in control group [−23.8 ± 13.7 mg/g Cr vs. 15.9 ± 13.2 mg/g Cr, mean ± S.E.M., P = 0.0114]. Mean blood pressure levels did not change before and during the observation period both in losartan group and control group, though only systolic blood pressure at home decreased slightly but significantly. There were no significant differences in the levels of HbA1c , fasting plasma glucose, total cholesterol, triglyceride and body mass index between the two groups. The observed decrease in UACR in the losartan-treated group might be attributed to a direct renoprotective action in addition to a subtle decrease in systolic blood pressure at home.