Why the study?
What are the pharmacokinetics, pharmacodynamics, and tolerability of losartan in hypertensive continuous ambulatory peritoneal dialysis patients?
What are the pharmacokinetics, pharmacodynamics, and tolerability of losartan in hypertensive continuous ambulatory peritoneal dialysis patients?
Losartan can be safely used in CAPD patients for hypertension management without requiring dose adjustments for peritoneal clearance.
Supports no peritoneal dose adjustment for losartan in CAPD; leaves open randomized confirmation of efficacy and safety.
The pharmacokinetics and pharmacodynamics of losartan and its active metabolite, E-3174, were studied in 8 stable, hypertensive continuous ambulatory peritoneal dialysis (CAPD) patients. Following a 1-week washout period, subjects received 100 mg of losartan orally for 7 days. On Days 1 and 7, hemodynamic and hormonal responses were determined, as were PK parameters on Day 7. Peritoneal equilibration testing was performed pre-Day 1 and on Day 7. AUC0-24 and t1/2 for losartan and E-3174 were 95 +/- 49.9 micrograms.min/mL and 176 +/- 82.1 micrograms.min/mL and 172.5 +/- 86.7 minutes and 628 +/- 575 minutes, respectively. These values are similar to those of normal subjects and subjects on hemodialysis. Peritoneal clearance of losartan and E-3174 was negligible. All subjects demonstrated a substantial reduction in blood pressure with at least a 10 mmHg drop in diastolic BP. Plasma renin activity (PRA) values increased, but aldosterone, endothelin, norepinephrine, and epinephrine values did not change following 7 days of losartan. Losartan was well tolerated in all study subjects.
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Pedro et al. (2000) studied this question.
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