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

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