Hippokratia 2001, 5 (4): 165-171
G Vergoulas, Gr Miserlis, V Papanikolaou, F Karasavvidou, M Leontsini, D Gakis, A Pantzaki, E Atmatzidis, D Takoudas D, A Antoniadis
The aim of this study was to investigate the safety and efficacy of angiotensin II receptor type 1 antagonists (AT1RA) on hypertensive renal transplant recipients with proteinuria. Eighteen pts with hypertension and proteinuria were included in the study. These pts (14 male, 4 female) with a mean age 48 years (range 31 to 64 years) received AT1RA (11 losartan, 7 valsartan) 4.33 years after Rt (0.5 to 11 years). All of them had a six month follow up before and after the initiation of AT1RA. Systolic (SBP) and diastolic blood pressure (DBP), serum creatinine (Scr) and Hb were recorded every two months during the follow up period. Proteinuria (Pr), number of antihypertensive agents (NAA) and cyclosporine levels (CyAl) were recorded at AT1RA treatment initiation and six months later. ANOVA for repeated measures and paired sample t test were used for statistical analysis. SBP/DBP measurements were 143.12±14.00/ 90.31±10.07 mmHg, 146.87±10.62/ 90.00±7.30 mmHg, 148.12+12.63/93.75±8.85 mm Hg, and 146.25±13.96/ 86.25±5.91 mmHg 6, 4, 2 and 0 months before AT1RA initiation respectively (p:NS) and 139.33±14.8/85.33±5.49 mmHg, 143.66±17.05 /86.00±8.06 mmHg and 142.33±10.99/87.33+8.42 mmHg 2, 4 and 6 months after AT1RA initiation respectively (p:NS). Scr was 1.53+0.55 mg/dl, 1.6l±0.70 mg/dl, 1.66+0.70 mg/dl and 1.68+0.71 mg/dl 6, 4, 2 and 0 months before AT IRA initiation respectively (p:NS) and 1.78±0.80 mg/dl, 1.84±0.87 mg/dl and 1.82±0.94 mg/dl 2, 4 and 6 months after AT1RA initiation respectively (p:NS). Hb was 12.80±2.11 g/dl, 12.57±1.78 g/dl, 12.73 ± 1.80 g/dl and 12.26+2.09 g/dl 6, 4, 2 and 0 months before AT1RA initiation respectively and 12.10±1.69 g/dl, 11.48±1.59 g/dl and 11.55±1.62 g/dl 2, 4 and 6 months after AT1RA initiation respectively (p:0.005). Pr was 0.76+0.77 g/dl g/24 h before and 0.61±0.63 g/24 h six months after AT1RA initiation (p:0.024). The NAA was 2.27+0.89 and 1.83+0.85 before and six months after AT1RA initiation (p:0.007). CyAl were 83.75±42.22 and 70.24±40.16 ng/L before and after AT1RA treatment (p:NS). In conclusion AT1RA reduce statistically significantly renal transplant recipient's proteinuria, control their hypertension efficiently, reduce the number of antihypertensive agents needed, do not cause impairment of renal function and cause a small but statistically significant fall of Hb.