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首页> 外文期刊>Current therapeutic research, clinical and experimental. >Olmesartan is More Effective Than Other Angiotensin Receptor Antagonists in Reducing Proteinuria in Patients With Chronic Kidney Disease Other Than Diabetic Nephropathy
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Olmesartan is More Effective Than Other Angiotensin Receptor Antagonists in Reducing Proteinuria in Patients With Chronic Kidney Disease Other Than Diabetic Nephropathy

机译：在糖尿病肾病患者以外的慢性肾脏病患者中，奥美沙坦比其他血管紧张素受体拮抗剂更有效地减少蛋白尿

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Background: Angiotensin II receptor antagonists (ARBs) have a protective effect in patients with chronic kidney disease (CKD) by suppressing progression, possibly by controlling hypertension. One marker of progression in such patients is the degree of proteinuria.Objective: We aimed to retrospectively examine the protective effect of ARBs (olmesartan, losartan, candesartan, and valsartan) on CKD patients without a history of diabetic nephropathy. Methods: Data were retrieved from medical records of patients with a diagnosis of CKD (serum creatinine [Cre] <3.0 mg/dL [265.2 nmol/L] and urinary protein of 0.3-3.5 g/g Cre) who were treated with ARBs and those with diabetic nephropathy were excluded. Blood pressure, serum Cre, urinary protein, urinary Cre, and estimated glomerular filtration rate were measured before the research began and at 1, 3, 6, 12, and 24 months after the ARB treatment was started. Results: Forty-four patients completed the research protocol. Of these, 10 took olmesartan, 13 took losartan, 9 took candesartan, 9 took valsartan, and 3 took telmisartan. Systolic blood pressure was decreased in all cases. The extent of this decrease 1 month after starting ARB treatment was greater for olmesartan than for candesartan (P < 0.05), and after 2 years, it was greater than for losartan (P < 0.05). Diastolic blood pressure decreased in all patients; this decrease was significantly greater with olmesartan 1 month after treatment started than with candesartan (P < 0.05). Olmesartan significantly decreased daily urinary protein compared with that with the other ARBs during follow-up. This decrease 1 month after starting ARB treatment was greater for olmesartan than Iosartan, valsartan, and candesartan (P < 0.01, P < 0.01, and P < 0.05, respectively), and after 2 years, this effect was still significant (P < 0.05, P < 0.01, and P < 0.01, respectively). Conclusions: Olmesartan is more effective in reducing urinary protein than other ARBs, suggesting that the renal protective effects of olmesartan may be better than those of other ARBs.
机译：背景：血管紧张素II受体拮抗剂（ARBs）通过抑制疾病进展，可能通过控制高血压，对慢性肾脏病（CKD）患者具有保护作用。这类患者进展的一个标志是蛋白尿程度。目的：我们旨在回顾性研究ARB（奥美沙坦，氯沙坦，坎地沙坦和缬沙坦）对无糖尿病肾病史的CKD患者的保护作用。方法：从诊断为CKD（血清肌酐[Cre] <3.0 mg / dL [265.2 nmol / L]和尿蛋白0.3-3.5 g / g Cre）的患者的病历中检索数据，并用ARB和抗凝剂治疗。那些患有糖尿病肾病的患者被排除在外。在研究开始之前和ARB治疗开始后的第1、3、6、12和24个月测量血压，血清Cre，尿蛋白，尿Cre和估计的肾小球滤过率。结果：44名患者完成了研究方案。其中，奥美沙坦占10片，洛沙坦占13片，坎地沙坦占9片，缬沙坦占9片，替米沙坦占3片。在所有情况下，收缩压均降低。奥美沙坦开始ARB治疗后1个月的下降幅度大于坎地沙坦（P <0.05），而两年后，其下降幅度大于氯沙坦（P <0.05）。所有患者的舒张压均下降;奥美沙坦治疗开始后1个月的下降明显大于坎地沙坦（P <0.05）。随访期间，奥美沙坦与其他ARBs相比，每日尿蛋白显着降低。在开始ARB治疗后1个月，奥美沙坦的下降幅度大于艾沙坦，缬沙坦和坎地沙坦（分别为P <0.01，P <0.01和P <0.05），并且在2年后，这种作用仍然很明显（P <0.05 ，P <0.01和P <0.01）。结论：奥美沙坦在减少尿蛋白方面比其他ARB更有效，这表明奥美沙坦的肾脏保护作用可能优于其他ARB。

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