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Randomized Controlled Trial
. 2016 Aug;18(8):741-9.
doi: 10.1111/jch.12745. Epub 2015 Dec 22.

Nebivolol Effects on Nitric Oxide Levels, Blood Pressure, and Renal Function in Kidney Transplant Patients

Alfonso H Santos Jr  1 , Michael J Casey  1 , Charles M Bucci  1 , Shehzad Rehman  1 , Mark S Segal  1
Affiliations
Randomized Controlled Trial

Nebivolol Effects on Nitric Oxide Levels, Blood Pressure, and Renal Function in Kidney Transplant Patients

Alfonso H Santos Jr et al. J Clin Hypertens (Greenwich). 2016 Aug.

Abstract

In hypertensive kidney transplant recipients, the effects of nebivolol vs metoprolol on nitric oxide (NO) blood level, estimated glomerular filtration rate (eGFR), and blood pressure (BP) have not been previously reported. In a 12-month prospective, randomized, open-label, active-comparator trial, hypertensive kidney transplant recipients were treated with nebivolol (n=15) or metoprolol (n=15). Twenty-nine patients (nebivolol [n=14], metoprolol [n=15]) completed the trial. The primary endpoint was change in blood NO level after 12 months of treatment. Secondary endpoints were changes in eGFR, BP, and number of antihypertensive drug classes used. After 12 months of treatment, least squares mean change in plasma NO level in the nebivolol kidney transplant recipient group younger than 50 years was higher by 68.19% (99.17% confidence interval [CI], 13.02-123.36), 69.54% (99.17% CI, 12.71-126.37), and 66.80% (99.17% CI, 12.95-120.64) compared with the metoprolol group younger than 50 years, the metoprolol group 50 years and older, and the nebivolol group 50 years and older, respectively. The baseline to month 12 change in mean arterial BP, eGFR, and number of antihypertensive drug classes used was not significantly different between the treatment groups. In hypertensive kidney transplant recipients, nebivolol use in patients younger than 50 years increased blood NO.

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Figures

Figure 1
Figure 1
Trial profile.
Figure 2
Figure 2
Plasma nitric oxide achieved at month 12 of nebivolol (Neb) or metoprolol (Met) treatment corrected for pretreatment level. LS indicates least square.
Figure 3
Figure 3
Percent change in plasma nitric oxide level from baseline to month 12 of nebivolol (Neb) or metoprolol (Met) treatment. LS indicates least square; CI, confidence interval.
Figure 4
Figure 4
Change in plasma nitric oxide (NO) level from baseline to month 12 of treatment: effect of nebivolol (Neb) or metoprolol (Met) with tacrolimus (FK) trough level categories <10 µg/L or >10 µg/L.
Figure 5
Figure 5
Percent change in glomerular filtration rate (GFR) after 12 months of nebivolol (Neb) or metoprolol (Met) treatment. Groups stratified by age of kidney donors (<50 years or >50 years).
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References

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