Glucose metabolism and blood pressure remain unchanged by addition of angiotensin receptor blocker in patients undergoing hemodialysis

BACKGROUND Angiotensin receptor blockers (ARBs) may exert effects on insulin sensitivity and blood pressure beyond those achieved by angiotensin‐converting enzyme inhibition (ACE‐I). The purpose of this study was to investigate whether this action is detectable in patients undergoing maintenance hemodialysis (HD) therapy. METHODS Twenty‐nine hypertensive HD patients, with ( n = 17) or without diabetes ( n = 12) received a daily add‐on therapy with 80 mg of telmisartan. Body mass index (BMI), fasting glucose, HbA1c, and blood pressure (BP) were recorded before and during 6 months of treatment. RESULTS HbA1c and blood glucose were higher in patients with diabetes at the beginning of the study and after 6 months. Fasting glucose tended to decrease over time in both groups of patients, but this change was not statistically significant. Likewise, HbA1c, BMI, and BP values remained unchanged. CONCLUSIONS Telmisartan does not improve glucose metabolism or lower blood pressure in patients receiving ACE‐I with or without diabetes undergoing maintenance HD. A preventive action on continuous deterioration of the clinical condition cannot be exluded.