Key result
Telmisartan produced significantly greater reductions in urinary L-FABP and 8-OHdG excretion after 12 months compared to losartan, candesartan, or olmesartan in early-stage diabetic nephropathy.
Why the study?
Does telmisartan improve urinary albumin excretion, L-FABP, and 8-OHdG levels more than other ARBs in early-stage diabetic nephropathy patients with microalbuminuria?
RCT (n=68)
Randomized
Does telmisartan improve urinary albumin excretion, L-FABP, and 8-OHdG levels more than other ARBs in early-stage diabetic nephropathy patients with microalbuminuria?
Telmisartan appears to provide more potent renoprotection, as measured by reductions in L-FABP and 8-OHdG, compared to losartan, candesartan, or olmesartan in early-stage diabetic nephropathy.
Telmisartan may be preferred for renoprotection in early diabetic nephropathy; extends ARB comparisons to L-FABP and oxidative stress markers.
BACKGROUND: There is increasing evidence that inhibition of the renin-angiotensin system provides renoprotection independent of blood pressure lowering. The aim of the present study was to determine whether various angiotensin II receptor blockers (ARBs) affect urinary albumin excretion (UAE), urinary liver-type fatty acid-binding protein (L-FABP) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels in early-stage diabetic nephropathy patients with microalbuminuria. METHODS: Sixty-eight diabetic nephropathy patients with microalbuminuria were randomly allocated to 1 of 4 treatment groups: losartan 100 mg/day (group A), candesartan 12 mg/day (group B), olmesartan 40 mg/day (group C), or telmisartan 80 mg/day (group D). Treatment was continued for 12 months. UAE, L-FABP and 8-OHdG excretion, serum creatinine, and 24-hour creatinine clearance (Ccr) were measured. RESULTS: The serum creatinine and 24-hour Ccr were not affected during the experimental period in any of the groups. Systolic and diastolic blood pressures, UAE, urinary L-FABP and 8-OHdG excretion were significantly reduced after 6 and 12 months compared with baseline in any of the groups. ΔL-FABP and Δ8-OHdG were significantly greater in group D than in the other 3 groups after 12 months. CONCLUSIONS: ARBs have renoprotection and this effect of telmisartan appears to be more potent than that of losartan, candesartan, or olmesartan in early-stage diabetic nephropathy patients.
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Nakamura et al. (2010) conducted an RCT in Early-stage diabetic nephropathy with microalbuminuria (n=68). Telmisartan vs. Losartan (100 mg/day), candesartan (12 mg/day), or olmesartan (40 mg/day) was evaluated on Urinary albumin excretion (UAE), urinary L-FABP, and 8-OHdG levels. Telmisartan produced significantly greater reductions in urinary L-FABP and 8-OHdG excretion after 12 months compared to losartan, candesartan, or olmesartan in early-stage diabetic nephropathy.
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