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January 1, 2004Scandinavian Journal of Urology and Nephrology

Low-dose angiotensin II receptor antagonists and angiotensin II-converting enzyme inhibitors alone or in combination for treatment of primary glomerulonephritis

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Key result

Low-dose losartan plus enalapril cuts proteinuria by ~63% at 3 months vs losartan alone.

  • P=0.02
  • n=54

Why the study?

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

Population

54 patients with biopsy-proven chronic glomerulonephritis, hypertension and normal or slightly impaired…

Comparison

Low-dose losartan alone or combination of… vs Low-dose enalapril (10 mg) alone

Design

RCT, randomized

Follow-up

9 months

Authors

MRMarcin RenkeLTLeszek TylickiPRPrzemysław Rutkowski

Discussion

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Overview

Supports low-dose ARB-ACEI combination for enhanced proteinuria control in hypertensive glomerulonephritis; extends dual RAS blockade evidence in proteinuric CKD.

Study Design

Type

RCT (n=54)

Randomization

randomized

Structured PICO

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

P
Population
54 patients with biopsy-proven chronic glomerulonephritis, hypertension, and normal or slightly impaired kidney function, followed for 9 months.
I
Intervention
Low-dose losartan (25 mg) alone or combination of losartan (25 mg) and enalapril (10 mg)
C
Comparator
Low-dose enalapril (10 mg) alone
O
Outcome
Changes in proteinuria, kidney function and metabolic profilesurrogate

Main Result

p-value: p=0.02

Low-dose ACE inhibitors, ARBs, or their combination significantly reduce proteinuria in patients with chronic glomerulonephritis, with the combination potentially offering additional early benefits.

Limitations

  • Small sample size
  • small sample size

Cite This Study

Renke et al. (2004) conducted an RCT in chronic glomerulonephritis (n=54). Losartan and enalapril combination vs. Losartan 25 mg alone or enalapril 10 mg alone was evaluated on Proteinuria reduction (p=0.02). Low-dose combination therapy with losartan and enalapril reduced proteinuria by 63% at 3 months, a significantly greater reduction compared to losartan alone (P=0.02).

synapsesocial.com/papers/6aa57cdea4e854736fdd45f3https://doi.org/10.1080/00365590410015687
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Also Consider

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

  1. 1Renoprotective Effect of Small Doses of Losartan and Enalapril in Patients with Primary Glomerulonephritis2002 · 46 citations
  2. 2Additive antiproteinuric effect of combined ACE inhibition and angiotensin II receptor blockade2002 · 126 citations
  3. 3Low-dose dual blockade of the renin–angiotensin system improves tubular status in non-diabetic proteinuric patients2005 · 12 citations
  4. 4Antiproteinuric efficacy of losartan in comparison with amlodipine in non-diabetic proteinuric renal diseases: a double-blind, randomized clinical trial2003 · 58 citations
  5. 5Dual Renin-Angiotensin System Blockade for Nephroprotection: Still under Scrutiny2014 · 25 citations