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Randomized Controlled Trial
. 2017 Oct;19(10):990-998.
doi: 10.1111/jch.13054. Epub 2017 Aug 28.

Antialbuminuric effect of eplerenone in comparison to thiazide diuretics in patients with hypertension

Toshiki Sawai  1 , Kaoru Dohi  1 , Naoki Fujimoto  1 , Setsuya Okubo  2 , Naoki Isaka  3 , Takehiko Ichikawa  2 , Katsutoshi Makino  4 , Shinya Okamoto  5 , Sukenari Koyabu  6 , Tetsuya Kitamura  7 , Toru Ogura  8 , Tomomi Yamada  9 , Satoshi Tamaru  8 , Masakatsu Nishikawa  8 , Mashio Nakamura  1 , Masaaki Ito  1 ; OWASE Study Investigators
Collaborators, Affiliations
Randomized Controlled Trial

Antialbuminuric effect of eplerenone in comparison to thiazide diuretics in patients with hypertension

Toshiki Sawai et al. J Clin Hypertens (Greenwich). 2017 Oct.

Abstract

This study investigated the effects and safety of eplerenone or thiazide diuretics in patients with hypertension and albuminuria (pretreatment urinary albumin/creatinine ratio ≥10 mg/gCr) treated with an angiotensin II receptor blocker. The primary end point was the mean percent change in the urinary albumin/creatinine ratio from baseline to 48 weeks. An efficacy analysis was performed in 195 patients (98 in the eplerenone group and 97 in the thiazide group). Systolic and diastolic blood pressures at 48 weeks were similar in the two groups. The mean percent change in the urinary albumin/creatinine ratio from baseline to 48 weeks was similar in the two groups (P=.804). In the safety analysis, the withdrawal rates for adverse events were similar in both groups. The antialbuminuric effects and safety of eplerenone therapy were similar to those of thiazide diuretics when combined with an angiotensin II receptor blocker in patients with hypertension and albuminuria.

Keywords: antihypertensive therapy; clinical trials; combination therapy; proteinuria; renal disease.

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Conflict of interest statement

Toshiki Sawai, Setsuya Okubo, Naoki Isaka, Takehiko Ichikawa, Katsutoshi Makino, Shinya Okamoto, Sukenari Koyabu, Naoki Fujimoto, Toru Ogura, Tomomi Yamada, and Satoshi Tamaru have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Participant flow. The efficacy analysis was performed in 195 patients with complete data sampling (98 in the eplerenone group and 97 in the thiazide diuretic group)
Figure 2
Figure 2
Time course of blood pressure (BP) (A) and urinary albumin/creatinine ratio (UACR) (B). Data are mean±SE. *P<.05 vs 0 wk
Figure 3
Figure 3
Changes from baseline in urinary albumin/creatinine ratio (UACR) at 48 weeks. All patients and subanalysis
See this image and copyright information in PMC

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