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January 1, 2006The Tohoku Journal of Experimental MedicineOpen Access

Losartan significantly retarded the progression of advanced renal insufficiency, improving the 1/sCr slope from -0.004 to -0.001 dl/mg/week over 24 weeks.

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Why the study?

Does losartan reduce the rate of renal function loss in hypertensive patients with advanced renal insufficiency?

Population

8 hypertensive patients with chronic renal disease and advanced renal insufficiency, mean age 55.6, 75%…

Comparison

Losartan 25-50 mg/day oral for 24 weeks vs Pre-treatment period

Design

Cohort

Follow-up

24 weeks

Key result

Losartan significantly retarded the progression of advanced renal insufficiency, improving the 1/sCr slope from -0.004 to -0.001 dl/mg/week over 24 weeks.

Authors

HOHiroshi OsawaNNNorio NakamuraKSK Shirato

Discussion

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Overview

Supports losartan for slowing renal decline in advanced insufficiency; hypothesis-generating, needs randomized confirmation before practice change.

Study Design

Type

Observational (n=8)

Multicenter

No

Structured PICO

Does losartan reduce the rate of renal function loss in hypertensive patients with advanced renal insufficiency?

P
Population
8 hypertensive patients with advanced chronic renal disease (baseline serum creatinine > 2.0 mg/dl) followed for 24 weeks before and after losartan initiation.
I
Intervention
Losartan 25-50 mg/day oral for 24 weeks
C
Comparator
Pre-treatment period (retrospective before-and-after comparison)
O
Outcome
Rate of renal function loss, measured by the slope of reciprocal of serum creatinine plotted against time (1/sCr slope) over 24 weekssurrogate

Main Result

Absolute Event Rate: -0.001% vs -0.004%

p-value: p=<0.05

In a small retrospective cohort, losartan significantly slowed the decline of renal function in patients with advanced renal insufficiency, independent of significant blood pressure changes.

Limitations

  • Short-term retrospective study
  • Small number of patients
  • Adequate blood pressure control was not achieved after the initiation of losartan
  • Proteinuria was not assessed quantitatively in all patients
  • Adequate blood pressure control was not achieved after initiation

Cite This Study

Osawa et al. (2006) conducted an observational in Advanced renal insufficiency (n=8). Losartan vs. Pre-treatment period was evaluated on Slope of reciprocal of serum creatinine plotted against time (1/sCr slope) (p=<0.05). Losartan significantly retarded the progression of advanced renal insufficiency, improving the 1/sCr slope from -0.004 to -0.001 dl/mg/week over 24 weeks.

synapsesocial.com/papers/6a207cf6a25331481ccd3fc2https://doi.org/10.1620/tjem.209.7
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effects of Losartan on Renal Function in Patients with Essential Hypertension1996 · 55 citations
  2. 2Reduced progression of adriamycin nephropathy in spontaneously hypertensive rats treated by losartan2008 · 29 citations
  3. 3Continuum of Renoprotection with Losartan at All Stages of Type 2 Diabetic Nephropathy2004 · 125 citations
  4. 4The antiproteinuric effect of losartan is systemic blood pressure dependent2003 · 7 citations
  5. 5Hypotensive Effect of Losartan, a Nonpeptide Angiotensin II Receptor Antagonist, in Essential Hypertension1993 · 109 citations