Comparison of the antialbuminuric effects of benidipine and hydrochlorothiazide in Renin-Angiotensin System (RAS) inhibitor-treated hypertensive patients with albuminuria: the COSMO-CKD (COmbination Strategy on Renal Function of Benidipine or Diuretics TreatMent with RAS inhibitOrs in a Chronic Kidney Disease Hypertensive Population) study. - OpacWWW

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Tytuł:: Comparison of the antialbuminuric effects of benidipine and hydrochlorothiazide in Renin-Angiotensin System (RAS) inhibitor-treated hypertensive patients with albuminuria: the COSMO-CKD (COmbination Strategy on Renal Function of Benidipine or Diuretics TreatMent with RAS inhibitOrs in a Chronic Kidney Disease Hypertensive Population) study.
Autorzy:: Ando K; 1. Division of Molecular Cardiovascular Metabolism, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Nitta K; 2. Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
Rakugi H; 3. Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, Suita, Japan.
Nishizawa Y; 4. Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
Yokoyama H; 5. Division of Nephrology, Kanazawa Medical University School of Medicine, Ishikawa, Japan.
Nakanishi T; 6. Department of Internal Medicine, Division of Kidney and Dialysis, Hyogo College of Medicine, Nishinomiya, Japan.
Kashihara N; 7. Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan.
Tomita K; 8. Department of Nephrology, Graduate School of Faculty of Life Science, Kumamoto University, Kumamoto, Japan.
Nangaku M; 9. Department of Nephrology and Endocrinology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Takahashi K; 9. Department of Nephrology and Endocrinology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Isshiki M; 9. Department of Nephrology and Endocrinology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Shimosawa T; 10. Department of Clinical Laboratory, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Fujita T; 11. Division of Clinical Epigenetics, Research Center for Advanced Science and Technology, University of Tokyo, Tokyo, Japan.
Źródło:: International journal of medical sciences [Int J Med Sci] 2014 Jun 21; Vol. 11 (9), pp. 897-904. Date of Electronic Publication: 2014 Jun 21 (Print Publication: 2014).
Typ publikacji:: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Original Publication: [Australia] : Ivyspring International Publisher, c2004-
MeSH Terms:: Dihydropyridines/*administration & dosage
Hydrochlorothiazide/*administration & dosage
Hypertension/*drug therapy
Renal Insufficiency, Chronic/*drug therapy
Adult ; Aged ; Albuminuria/chemically induced ; Albuminuria/pathology ; Amlodipine/therapeutic use ; Blood Pressure/drug effects ; Female ; Glomerular Filtration Rate/drug effects ; Humans ; Hypertension/complications ; Hypertension/pathology ; Male ; Middle Aged ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/pathology ; Renin-Angiotensin System/drug effects
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Contributed Indexing:: Keywords: L-/N-/T-type calcium channel blocker, thiazide diuretic, urinary albumin.; chronic kidney disease, hypertension, renin-angiotensin system inhibitor
Substance Nomenclature:: 0 (Dihydropyridines)
0J48LPH2TH (Hydrochlorothiazide)
1J444QC288 (Amlodipine)
4G9T91JS7E (benidipine)
Entry Date(s):: Date Created: 20140712 Date Completed: 20150330 Latest Revision: 20211021
Update Code:: 20240104
PubMed Central ID:: PMC4081312
DOI:: 10.7150/ijms.9026
PMID:: 25013370
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Objective: This study evaluated the non-inferiority of renoprotection afforded by benidipine versus hydrochlorothiazide in hypertensive patients with chronic kidney disease (CKD).
Methods: In this prospective, multicenter, open-labeled, randomized trial, the antialbuminuric effects of benidipine and hydrochlorothiazide were examined in renin-angiotensin system (RAS) inhibitor-treated patients with blood pressure (BP) readings of ≥ 130/80 mmHg and ≤ 180/110 mmHg, a urinary albumin to creatinine ratio (UACR) of ≥ 300 mg/g, and an estimated glomerular filtration rate (eGFR) of ≥ 30 ml/min/1.73m(2). Patients received benidipine (n = 176, final dose: 4.8 mg/day) or hydrochlorothiazide (n = 170, 8.2 mg/day) for 12 months.
Results: Benidipine and hydrochlorothiazide exerted similar BP- and eGFR-decreasing actions. The UACR values for benidipine and hydrochlorothiazide were 930.8 (95% confidence interval: 826.1, 1048.7) and 883.1 (781.7, 997.7) mg/g at baseline, respectively. These values were reduced to 790.0 (668.1, 934.2) and 448.5 (372.9, 539.4) mg/g at last observation carried forward (LOCF) visits. The non-inferiority of benidipine versus hydrochlorothiazide was not demonstrated (benidipine/hydrochlorothiazide ratio of LOCF value adjusted for baseline: 1.67 (1.40, 1.99)).
Conclusions: The present study failed to demonstrate the non-inferiority of the antialbuminuric effect of benidipine relative to that of hydrochlorothiazide in RAS inhibitor-treated hypertensive patients with macroalbuminuria.

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