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Aliskiren Helps Improve Albuminuria in Patients with Diabetic Nephropathy
Adding the renin inhibitor aliskiren to optimal antihypertensive therapy reduces albuminuria in patients with diabetic nephropathy, reports the New England Journal of Medicine.
In a manufacturer-supported study, some 600 adults with hypertension, type 2 diabetes, and proteinuria took open-label losartan plus other antihypertensives as needed for 3 months, after which they were randomized to add-on therapy with daily aliskiren (Tekturna) or placebo for 6 months.
At the end of treatment, aliskiren was associated with a significant, 20% reduction in the mean urinary albumin-to-creatinine ratio, relative to placebo. The decrease was independent of the drug's small effect on blood pressure.
In Journal Watch Cardiology, Joel M. Gore calls for additional research to determine whether aliskiren's renoprotective effects translate into "true reductions in kidney failure or cardiovascular events." And in Journal Watch General Medicine, Allan S. Brett concludes: "Use of aliskiren solely to reduce proteinuria seems premature."
LINK(S):
NEJM article (Free abstract; full text requires subscription)
NEJM editorial (Subscription required)
Journal Watch Cardiology summary (Free)
Journal Watch General Medicine summary (Subscription required)
Physician's First Watch coverage of aliskiren approval (Free)
Published in Physician's First Watch June 5, 2008
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