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Journal of Renin-Angiotensin-Aldosterone System
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Antiproteinuric effect of candesartan cilexetil in patients with chronic glomerulonephritis

Kiyoshi Kurokawa

Department of Internal Medicine V, School of Medicine, Tokai University, Isehara, Kanagawa, Japan, kurokawa@ is.icc.u-tokai.ac.jp

Keishi Abe

Division of Internal Medicine, Sendai Social Insurance Hospital, Sendai, Miyagi, Japan

Takao Saruta

Department of Internal Medicine, School of Medicine, Keio University, Shinjuku, Tokyo, Japan

Masaaki Arakawa

Department of Internal Medicine , Niigata University School of Medicine, Niigata, Niigata, Japan

Ryuichi Kikkawa

Department of Internal Medicine , Shiga University of Medical Science, Ohtsu, Shiga, Japan

Naohiko Ueda

Nara Institute of Science and Technology Healthcare Center, Ikoma, Nara, Japan

Kaoru Onoyama

Division of Internal Medicine, Nippon Steel Yawata Memorial Hospital, Kita-Kyushu, Fukuoka, Japan

Kimio Tomita

Division of Internal Medicine, Sendai Social Insurance Hospital, Sendai, Miyagi, Japan

Nobuya Ogawa

Ehime University, Matsuyama, Ehime, Japan

A prospective, randomised, double-blind, parallel-group, dose-response trial was conducted to investigate the antiproteinuric effect of candesartan cilexetil, the angiotensin II type 1 receptor blocker, in patients with chronic glomerulonephritis. Patients (n=280) were treated for 12 weeks with candesartan cilexetil 2, 4, or 8 mg given orally once-daily (o.d.). The improvement in urinary protein excretion observed at the end of the treatment period was 15.9% in the 2 mg group, 25.6% in the 4 mg group, and 34.6% in the 8 mg group, respectively, showing a clear dose-response (2 mg <4 mg <8 mg; p=0.003). The mean reduction in urinary protein excretion was 11.3% in the 2 mg group, 26.3% in the 4 mg group, and 26.0% in the 8 mg group, showing a dose-response pattern, in that the effect of 4 mg and 8 mg was greater than that of 2 mg (2 mg <4 mg ~8 mg; p=0.010). As the observed reduction in urinary protein excretion failed to correlate with changes in mean blood pressure, it could not be attributed to the antihypertensive effect of the study drug alone. This suggests that candesartan cilexetil, 4—8 mg o.d., has antiproteinuric effects in patients with chronic glomerulonephritis.

Key Words: candesartan cilexetil • glomerulonephritis • antiproteinuric effect • prospective randomised clinical trial

Journal of Renin-Angiotensin-Aldosterone System, Vol. 3, No. 3, 167-175 (2002)
DOI: 10.3317/jraas.2002.037
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