Comparison between the Angiotensin II Receptor Antagonist Candesartan Cilexetil and the Angiotensin-Converting Enzyme Inhibitor Trandolapril in Microalbuminuria of Patients with Early Diabetic Nephropathy

Nakamura, Tsukasa; Ushiyama, Chifuyu; Suzuki, Shingo; Shimada, Noriaki; Sekizuka, Keiko; Ebihara, Isao; Tanaka, Araki; Koide, Hikaru

doi:10.1159/000045773

Cited by 7 publications

(2 citation statements)

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“…We reported recently that candesartan cilexetil has a renoprotective efficacy similar to that of trandolapril not related to a decrease in blood pressure in normotensive microalbuminuric patients with diabetic nephropathy [13]. The present study was designed to examine whether urinary podocytes are useful markers of disease activity in adults with IgA nephropathy and whether verapamil, trandolapril and candesartan cilexetil affect urinary podocytes.…”

Section: Introductionmentioning

confidence: 93%

Effects of Angiotensin-Converting Enzyme Inhibitor, Angiotensin II Receptor Antagonist and Calcium Antagonist on Urinary Podocytes in Patients with IgA Nephropathy

et al. 2000

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The urinary podocyte is postulated to be a marker for estimation of the severity of active glomerular injury and a predictor of disease progression in children with glomerulonephritis. Non-dihydropyridine calcium antagonist, including verapamil, reduce proteinuria to an extent similar to that of the angiotensin-converting enzyme inhibitor (ACEI), including trandolapril, but to a greater extent than other antihypertensives. Angiotensin (Ang) II receptor antagonists, including candesartan cilexetil, show potent and long-term preventive effects against the progression of renal injury. The aim of the present study is to assess whether verapamil, trandolapril and candesartan cilexetil affect proteinuria and urinary podocytes in patients with IgA nephropathy. Thirty-two normotensive patients aged 18-54 years with biopsy-proven IgA nephropathy, nonnephrotic proteinuria (1-3 g/day), and normal renal function (creatinine clearance >80 ml/min) were studied. Twenty patients with diffuse mesangial proliferative glomerulonephritis (non-IgA PGN) and 20 healthy controls were also included in this study. The number of urinary podocytes in patients with advanced IgA nephropathy (n = 16) was significantly higher than that in patients with the disease in the mild stage (n = 16) (p < 0.01) or in patients with non-IgA PGN (p < 0.01). Urinary podocytes were not detected in healthy controls. The 32 patients with IgA nephropathy were randomly divided into four treatment groups: those treated with verapamil (120 mg/day, n = 8); those treated with trandolapril (2 mg/day, n = 8); those treated with candesartan cilexetil (8 mg/day, n = 8), and those given a placebo (n = 8). Treatment continued for 3 months. Antiproteinuric response in the trandolapril group was similar to that in the candesartan cilexetil group (-38 vs. -40%). The action of trandolapril or candesartan cilexetil was greater than that of verapamil (p < 0.01). Reduction in the number of urinary podocytes from baseline was significantly greater in patients treated with trandolapril or candesartan cilexetil than in patients treated with verapamil (p < 0.01). However, there was no difference between patients treated with trandolapril and those treated with candesartan cilexetil. Proteinuria and urinary podocytes were unaffected in the placebo group. These data suggest that urinary podocytes may be a marker of disease activity in adult patients with IgA nephropathy and that trandolapril and candesartan cilexetil are more effective than verapamil in reducing the number of podocytes.

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Section: Introductionmentioning

confidence: 93%

Effects of Angiotensin-Converting Enzyme Inhibitor, Angiotensin II Receptor Antagonist and Calcium Antagonist on Urinary Podocytes in Patients with IgA Nephropathy

et al. 2000

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“…Another study compared candesartan cilexetil with trandolapril in patients with early diabetic nephropathy. After 8 weeks' treatment, microalbuminuria was reduced to the same extent in each group [34]. Other studies also confirm these findings [35,36] and in summary, none of the surrogate studies has shown ARBs to be superior to ACE inhibitors.…”

Section: Discussionmentioning

confidence: 69%

Angiotensin receptor blockers as anti‐hypertensive treatment for patients with diabetes mellitus: meta‐analysis of controlled double‐blind randomized trials

Siebenhofer¹,

Plank²,

Horvath³

et al. 2004

Diabetic Medicine

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Angiotensin-converting-enzyme inhibitors and angiotensin receptor blockers for preventing the progression of diabetic kidney disease

Natale,

Palmer,

Navaneethan

et al. 2024

Cochrane Database of Systematic Reviews

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Comparison between the Angiotensin II Receptor Antagonist Candesartan Cilexetil and the Angiotensin-Converting Enzyme Inhibitor Trandolapril in Microalbuminuria of Patients with Early Diabetic Nephropathy

Cited by 7 publications

References 6 publications

Effects of Angiotensin-Converting Enzyme Inhibitor, Angiotensin II Receptor Antagonist and Calcium Antagonist on Urinary Podocytes in Patients with IgA Nephropathy

Effects of Angiotensin-Converting Enzyme Inhibitor, Angiotensin II Receptor Antagonist and Calcium Antagonist on Urinary Podocytes in Patients with IgA Nephropathy

Angiotensin receptor blockers as anti‐hypertensive treatment for patients with diabetes mellitus: meta‐analysis of controlled double‐blind randomized trials

Angiotensin-converting-enzyme inhibitors and angiotensin receptor blockers for preventing the progression of diabetic kidney disease

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