Individual long-term albuminuria exposure during angiotensin receptor blocker therapy is the optimal predictor for renal outcome

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
Tobias Felix KröpelinHiddo J L Heerspink

Abstract

Albuminuria reduction due to angiotensin receptor blockers (ARBs) predicts subsequent renoprotection. Relating the initial albuminuria reduction to subsequent renoprotection assumes that the initial ARB-induced albuminuria reduction remains stable during follow-up. The aim of this study was to assess individual albuminuria fluctuations after the initial ARB response and to determine whether taking individual albuminuria fluctuations into account improves renal outcome prediction. Patients with diabetes and nephropathy treated with losartan or irbesartan in the RENAAL and IDNT trials were included. Patients with >30% reduction in albuminuria 3 months after ARB initiation were stratified by the subsequent change in albuminuria until Month 12 in enhanced responders (>50% albuminuria reduction), sustained responders (between 20 and 50% reduction), and response escapers (<20% reduction). Predictive performance of the individual albuminuria exposure until Month 3 was compared with the exposure over the first 12 months using receiver operating characteristics (ROC) curves. Following ARB initiation, 388 (36.3%) patients showed an >30% reduction in albuminuria. Among these patients, the albuminuria level further decreased in 174 (44.8%)...Continue Reading

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Citations

Feb 26, 2016·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Richard J Glassock
Nov 18, 2017·Expert Opinion on Drug Discovery·Matthew D Breyer, Matthias Kretzler
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Nov 12, 2019·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Friedrich C PrischlChristoph Wanner
Jul 15, 2018·Clinical and Experimental Nephrology·Eiichiro KandaUNKNOWN Research Working Group for Establishing Guidelines for Clinical Evaluation of Chronic Kidney Disease
Apr 22, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Charlotte E BryantRonald J Hogg

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