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January 1, 2002American Journal of Nephrology

Renoprotective Effect of Small Doses of Losartan and Enalapril in Patients with Primary Glomerulonephritis

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Key result

Combined therapy with small doses of losartan and enalapril reduced proteinuria by 65.96%, which was significantly more pronounced than losartan monotherapy (25.35%; p=0.009).

Why the study?

Does low-dose losartan, enalapril, or their combination reduce proteinuria in patients with primary glomerulonephritis?

Population

51 patients with biopsy proven chronic glomerulonephritis with normal or slightly declined kidney function.

Comparison

Losartan 25 mg, enalapril 10 mg, or a… vs Active comparators.

Design

RCT, randomized

Follow-up

3 months

Authors

LTLeszek TylickiPRPrzemysław RutkowskiMRMarcin Renke

Discussion

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Overview

Low-dose losartan-enalapril combination yields greater proteinuria reduction than monotherapy in primary glomerulonephritis; extends dual RAAS blockade evidence while warranting GFR monitoring.

Study Design

Type

RCT (n=51)

Randomization

randomized

Structured PICO

Does low-dose losartan, enalapril, or their combination reduce proteinuria in patients with primary glomerulonephritis?

P
Population
51 patients with biopsy-proven chronic glomerulonephritis and normal or slightly declined kidney function, followed for 3 months.
I
Intervention
Losartan 25 mg (n=17), enalapril 10 mg (n=17), or a combination of losartan 25 mg and enalapril 10 mg (n=15) for 3 months.
C
Comparator
Active comparators (losartan vs. enalapril vs. combination).
O
Outcome
Proteinuria, kidney function (creatinine clearance), and metabolic profile at 3 months.surrogate

Main Result

Absolute Event Rate: 65.96% vs 25.35%

p-value: p=0.009

In patients with primary glomerulonephritis, combining low doses of losartan and enalapril provides greater antiproteinuric effects than monotherapy, though enalapril may carry a higher risk of acute GFR decline.

Cite This Study

Tylicki et al. (2002) conducted an RCT in chronic glomerulonephritis (n=51). Combination of losartan and enalapril vs. losartan 25 mg or enalapril 10 mg monotherapy was evaluated on reduction of proteinuria (p=0.009). Combined therapy with small doses of losartan and enalapril reduced proteinuria by 65.96%, which was significantly more pronounced than losartan monotherapy (25.35%; p=0.009).

synapsesocial.com/papers/6a9df70b6dfa5258fec3c15ehttps://doi.org/10.1159/000065227
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Also Consider

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

  1. 1Low-dose angiotensin II receptor antagonists and angiotensin II-converting enzyme inhibitors alone or in combination for treatment of primary glomerulonephritis2004 · 28 citations
  2. 2Effect of enalapril and losartan on proteinuria in type 2 diabetic nephropathy patients2009 · 5 citations
  3. 3Antiproteinuric efficacy of losartan in comparison with amlodipine in non-diabetic proteinuric renal diseases: a double-blind, randomized clinical trial2003 · 58 citations
  4. 4Low-dose dual blockade of the renin–angiotensin system improves tubular status in non-diabetic proteinuric patients2005 · 12 citations
  5. 5Anti-proteinuric effects of combination therapy with enalapril and losartan in patients with nephropathy due to type 2 diabetes2004 · 31 citations