Aliskiren Plus Losartan Equals Lower Urine Protein Levels in Type 2 Patients

Adding aliskiren to antihypertension regimens that already include losartan reduced blood protein levels from 19% to 22% in hypertensive type 2 diabetic patients with nephropathy, a Danish-led research team reported in the May edition of the Clinical Journal of the American Society of Nephrology.¹  These effects were consistent across range of patient blood pressures, the researchers reported.

The post-hoc study focused on blood pressure’s influence on urine protein levels in the Aliskiren in the Evaluation of Proteinuria in Diabetes (AVOID) study. In that study, 599 hypertensive Type 2 diabetic patients with nephropathy received six months of either aliskiren or a placebo added to losartan, as well as additional antihypertensive therapy aiming at target blood pressure below 130/80 mmHg.

The study’s authors grouped patients based on blood pressure. One group had blood pressure below 130/80 mmHg; a second spanned 130/80 to 140/90 mmHg, and a third, with insufficient blood pressure control, came in greater than 140/90 mmHg.

Across the board, blood pressure during the trial was consistent with baseline measurements, and the antiproteinuric effects of aliskiren held across the blood-pressure groupings. In addition, in the group with the highest blood pressure, renal function was better preserved with aliskiren, with patients showing significantly less decline in eGFR than with the placebo, the researchers reported.

1. Persson F et al. Aliskiren in Combination with Losartan Reduces Albuminuria Independent of Baseline Blood Pressure in Patients with Type 2 Diabetes and Nephropathy. Clin J Am Soc Nephrol 6: 1025-1031, May 2011.