Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland.
Int Urol Nephrol. 2012 Dec;44(6):1763-70. doi: 10.1007/s11255-011-0110-z.
To evaluate the proteinuria-lowering effect of a renin inhibitor (aliskiren), compared to placebo and to an angiotensin-converting enzyme inhibitor (perindopril), in patients with non-diabetic chronic kidney disease.
A randomised, double-blind, crossover trial was performed in 14 patients with nondiabetic chronic kidney disease with 24-h mean proteinuria of 2.01 g (95% CI, 1.36–2.66) and estimated creatinine clearance of 93±6.8 ml/min. The study consisted of five treatment periods. The patients were randomly assigned to receive aliskiren (150 mg), aliskiren (300 mg), perindopril (5 mg), perindopril (10 mg) or placebo.
Aliskiren and perindopril reduced proteinuria. These effects were dose-dependent. Furthermore, 24-h proteinuria was reduced by 23% (mean 95% CI; 2–44) by treatment with aliskiren (150 mg), by 36% (95% CI, 17–55; P<0.001) with aliskiren (300 mg), by 7.1% (95% CI, 11–26) with perindopril (5 mg) and by 25% (95% CI, 11–39; P<0.05) with perindopril (10 mg), compared to placebo. No significant difference was found between the effects of aliskiren and perindopril.
Aliskiren significantly reduced proteinuria. The antiproteinuric effect is probably similar to that of perindopril, for equivalent hypotensive dosages. The renin inhibitor provides a promising alternative approach for the treatment of patients with chronic proteinuric non-diabetic kidney disease.
评估肾素抑制剂（阿利克仑）在非糖尿病慢性肾病患者中降低蛋白尿的效果，与安慰剂和血管紧张素转换酶抑制剂（培哚普利）进行比较。
这是一项在 14 名非糖尿病慢性肾病患者中进行的随机、双盲、交叉试验，这些患者的 24 小时平均蛋白尿为 2.01g（95%可信区间，1.36-2.66），估算的肌酐清除率为 93±6.8ml/min。该研究包括五个治疗期。患者被随机分配接受阿利克仑（150mg）、阿利克仑（300mg）、培哚普利（5mg）、培哚普利（10mg）或安慰剂。
阿利克仑和培哚普利均降低蛋白尿。这些效果是剂量依赖性的。此外，阿利克仑（150mg）治疗使 24 小时蛋白尿减少 23%（平均 95%可信区间，2-44），阿利克仑（300mg）治疗使蛋白尿减少 36%（95%可信区间，17-55；P<0.001），培哚普利（5mg）治疗使蛋白尿减少 7.1%（95%可信区间，11-26），培哚普利（10mg）治疗使蛋白尿减少 25%（95%可信区间，11-39；P<0.05），与安慰剂相比。阿利克仑和培哚普利的作用之间未发现显著差异。
阿利克仑显著降低蛋白尿。降蛋白尿的效果可能与培哚普利相似，在等效的降压剂量下。肾素抑制剂为治疗慢性蛋白尿性非糖尿病肾病患者提供了一种有前景的替代方法。
