Antihypertensive Therapy in Non-Diabetic Chronic Kidney Disease Associated with Proteinuria in Adults

Khawar Maqsood, Adeel Siddiqui, Geoffrey Teehan

Department of Medicine, Baystate Medical Center, Tufts University School of Medicine, Springfield, USA.
Department of Nephrology, Lankenau Medical Center, Lankenau Institute for Medical Research, Wynnewood, USA.

DOI: 10.4236/ojneph.2013.33024                

Abstract

Controlling blood pressure and reducing proteinuria are common goals in Chronic Kidney Disease associated with hypertension and proteinuria and lead to fewer cardiovascular outcomes. This review summarizes the available literature.

Keywords

Hypertension; Proteinuria; Chronic Kidney Disease

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	P. A. Sarafidis, N. Khosla and G. L. Bakris, “Antihypertensive Therapy in the Presence of Proteinuria,” American Journal of Kidney Diseases, Vol. 49, No. 1, 2007, pp. 12-26. doi:10.1053/j.ajkd.2006.10.014
[2]	T. Yoshioka, H. G. Rennke, D. J. Salant, W. M. Deen and I. Ichikawa, “Role of Abnormally High Transmural Pressure in the Permselectivity Defect of Glomerular Capillary Wall: A Study in Early Passive Heymann Nephritis,” Circulation Research, Vol. 61, No. 4, 1987, p. 531. doi:10.1161/01.RES.61.4.531
[3]	R. T. Gansevoort, D. de Zeeuw and P. E. de Jong, “Dissociation between the Course of the Hemodynamic and Antiproteinuric Effects of Angiotensin I Converting Enzyme Inhibition,” Kidney International, Vol. 44, No. 3, 1993, pp. 579-584. doi:10.1038/ki.1993.284
[4]	J. E. Heeg, P. E. de Jong, G. K. van der Hem and D. de Zeeuw, “Angiotensin II Does Not Acutely Reverse the Reduction of Proteinuria by Long-Term ACE Inhibition,” Kidney International, Vol. 40, No. 4, 1991, pp. 734-741. doi:10.1038/ki.1991.268
[5]	F. N. Ziyadeh and G. Wolf, “Pathogenesis of the Podocytopathy and Proteinuria in Diabetic Glomerulopathy,” Current Diabetes Reviews, Vol. 4, No. 1, 2008, pp. 39-45. doi:10.2174/157339908783502370
[6]	R. G. Langham, D. J. Kelly, A. J. Cox, N. M. Thomson, H. Holthfer, P. Zaoui, N. Pinel, D. J. Cordonnier and R. E. Gilbert, “Proteinuria and the Expression of the Podocyte Slit Diaphragm Protein, Nephrin, in Diabetic Nephropathy: Effects of Angiotensin Converting Enzyme Inhibition,” Diabetologia, Vol. 45, No. 11, 2002, pp. 1572-1576. doi:10.1007/s00125-002-0946-y
[7]	T. H. Jafar, C. H. Schmid, M. Landa, I. Giatras, R. Toto, G. Remuzzi, G. Maschio, B. M. Brenner, A. Kamper, P. Zucchelli, G. Becker, A. Himmelmann, K. Bannister, P. Landais, S. Shahinfar, P. E. de Jong, D. de Zeeuw, J. Lau and A. S. Levey, “Angiotensin-Converting Enzyme Inhibitors and Progression of Nondiabetic Renal Disease. A Meta-Analysis of Patient-Level Data,” Annals of Internal Medicine, Vol. 135, No. 2, 2001, pp. 73-87. doi:10.7326/0003-4819-135-2-200107170-00007
[8]	D. M Kent, T. H. Jafar, R. A. Hayward, H. Tighiouart, M. P. Landa, de Jong, D. de Zeeuw, G. Remuzzi, A. L. Kamper and A. S. Levey, “Progression Risk, Urinary Protein Excretion, and Treatment Effects of Angiotensin-Converting Enzyme Inhibitors in Nondiabetic Kidney Disease,” Journal of the American Society of Nephrology, Vol. 18, No. 6, 2007, pp. 1959-1965. doi:10.1681/ASN.2006101081
[9]	A. Maione, S. D. Navaneethan, G. Graziano, R. Mitchell, D. Johnson, J. F. Mann, P. Gao, J. C. Craig, G. Tognoni, V. Perkovic, A. Nicolucci, S. De Cosmo, A. Sasso, O. Lamacchia, M. Cignarelli, V. M. Manfreda, G. Gentile and G. F. Strippoli, “Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers and Combined Therapy in Patients with Microand Macroalbuminuria and Other Cardiovascular Risk Factors: A Systematic Review of Randomized Controlled Trials,” Nephrology Dialysis Transplantation, Vol. 26, No. 9, 2011, pp. 2827-2847. doi:10.1093/ndt/gfq792
[10]	G. Maschio, D. Alberti, G. Janin, F. Locatelli, J. F. Mann, M. Motolese, C. Ponticelli, E. Ritz and P. Zucchelli, “Effect of the Angiotensin-Converting-Enzyme Inhibitor Benazepril on the Progression of Chronic Renal Insufficiency,” The New England Journal of Medicine, Vol. 334, No. 15, 1996, pp. 939-945. doi:10.1056/NEJM199604113341502
[11]	The GISEN Group “Randomised Placebo-Controlled Trial of Effect of Ramipril on Decline in glomerular Filtration Rate and Risk of Terminal Renal Failure in Proteinuric, Non-Diabetic Nephropathy,” Lancet, Vol. 349, No. 9069, 1997, pp. 1857-1863. doi:10.1016/S0140-6736(96)11445-8
[12]	P. Ruggenenti, A. Perna, G. Gherardi, F. Gaspari, R. Benini and G. Remuzzi, “Renal Function and Requirement for Dialysis in Chronic Nephropathy Patients on LongTerm Ramipril: REIN Follow-Up Trial,” Gruppo Italiano di Studi Epidemiologici in Nefrologia (GISEN). Ramipril Efficacy in Nephropathy. Lancet, Vol. 352, No. 9136, 1998, pp. 1252-1256. doi:10.1016/S0140-6736(98)04433-X
[13]	P. Ruggenenti, A. Perna, G. Loriga, M. Ganeva, B. EneIordache, M. Turturro, M. Lesti, E. Perticucci, I. N. Chakarski, D. Leonardis, G. Garini, A. Sessa, C. Basile, M. Alpa, R. Scanziani, G. Sorba, C. Zoccali and G. Remuzzi, “REIN-2 Study Group Blood-Pressure Control for Reno Protection in Patients with Non-Diabetic Chronic Renal Disease (REIN-2): Multi Centre Randomized Controlled Trial,” Lancet, Vol. 365, No. 9463, 2005, pp. 939-946. doi:10.1016/S0140-6736(05)71082-5
[14]	J. T. Wright Jr, G. Bakris, T. Greene, L. Y. Agodoa, L. J. Appel, J. Charleston, D. Cheek, J. G. Douglas-Baltimore, J. Gassman, R. Glassock, L. Hebert, K. Jamerson, J. Lewis, R. A. Phillips, R. D. Toto, J. P. Middleton, S. G. Rostand and African American Study of Kidney Disease and Hypertension Study Group, “Effect of Blood Pressure Lowering and Antihypertensive Drug Class on Progression of Hypertensive Kidney Disease: Results from the AASK Trial,” Journal of the American Medical Association, Vol. 288, No. 19, 2002, pp. 2421-2431. doi:10.1001/jama.288.19.2421
[15]	L. J. Appel, J. T. Wright Jr., T. Greene, J. W. Kusek, J. B. Lewis, X. Wang, M. S. Lipkowitz, K. C. Norris, G. L. Bakris, M. Rahman, G. Contreras, S. G. Rostand, J. D. Kopple, F. B. Gabbai, G. I. Schulman, J. J. Gassman, J. Charleston and L. Y. Agodoa, “African American Study of Kidney Disease and Hypertension Collaborative Research Group Long-Term Effects of Renin-Angiotensin System-Blocking Therapy and a Low Blood Pressure Goal on Progression of hypertensive Chronic Kidney Disease in African Americans,” JAMA Internal Medicine, Vol. 168, No. 8, 2008, pp. 832-839. doi:10.1001/archinte.168.8.832
[16]	F. F. Hou, X. Zhang, G. H. Zhang, D. Xie, P Y. Chen, W. R. Zhang, J. P. Jiang, M. Liang, G. B. Wang, Z. R. Liu and R. W. Geng, “Efficacy and Safety of Benazepril for Advanced Chronic Renal Insufficiency,” The New England Journal of Medicine, Vol. 354, No. 2, 2006, pp. 131-140. doi:10.1056/NEJMoa053107
[17]	A. M. O'Hare, J. S. Kaufman, K. E. Covinsky, C. S. Landefeld, L. V. McFarland and E. B. Larson, “Current Guidelines for Using Angiotensin-Converting Enzyme Inhibitors and Angiotensin II-Receptor Antagonists in Chronic Kidney Disease: Is the evidence Base Relevant to Older Adults?” Annals of Internal Medicine, Vol. 150, No. 10, 2009, pp. 717-724. doi:10.7326/0003-4819-150-10-200905190-00010
[18]	R. Kunz, C. Friedrich, M. Wolbers and J. F. Mann, “MetaAnalysis: Effect of Monotherapy and Combination Therapy with Inhibitors of the Renin Angiotensin System on Proteinuria in Renal Disease,” Annals of Internal Medicine, Vol. 148, No. 1, 2008, pp. 30-48. doi:10.7326/0003-4819-148-1-200801010-00190
[19]	S. W. Tobe, C. M. Clase, P. Gao, M. McQueen, A. Grosshennig, X. Wang, K. K. Teo, S. Yusuf and J. F. Mann, “Cardiovascular and Renal Outcomes with Telmisartan, Ramipril, or Both in People at High Renal Risk: Results from the ONTARGET and TRANSCEND Studies,” Circulation, Vol. 123, No. 10, 2011, pp. 1098-1107. doi:10.1161/CIRCULATIONAHA.110.964171
[20]	M. MacKinnon, S. Shurraw, A. Akbari, G. A. Knoll, J. Jaffey and H. D. Clark, “Combination Therapy with an Angiotensin Receptor Blocker and an ACE Inhibitor in Proteinuric Renal Disease: A Systematic Review of the Efficacy and Safety Data,” American Journal of Kidney Diseases, Vol. 48, No. 1, 2006, pp. 8-20. doi:10.1053/j.ajkd.2006.04.077
[21]	G. L. Bakris, M. R. Weir, M. Secic, B. Campbell and A. Weis-McNulty, “Differential Effects of Calcium Antagonist Subclasses on Markers of Nephropathy Progression,” Kidney International, Vol. 65, No. 6, 2004, pp. 1991-2002. doi:10.1111/j.1523-1755.2004.00620.x
[22]	S. D. Navaneethan, S. U. Nigwekar, A. R. Sehgal and G. F. Strippoli, “Aldosterone Antagonists for Preventing the Progression of Chronic Kidney Disease: A Systematic Review and Meta-Analysis,” Clinical Journal of the American Society of Nephrology, Vol. 4, No. 3, 2009, pp. 542-551. doi:10.2215/CJN.04750908
[23]	B. H. Oh, J. Mitchell, J. R. Herron, J. Chung, M. Khan and D. L. Keefe, “Aliskiren, an Oral Renin Inhibitor, Provides Dose-Dependent Efficacy and Sustained 24-Hour Blood Pressure Control in Patients with Hypertension,” Journal of the American College of Cardiology, Vol. 49, No. 11, 2007, pp. 1157-1163. doi:10.1016/j.jacc.2006.11.032
[24]	J. L. Pool, R. E. Schmieder, M. Azizi, J. C. Aldigier, A. Januszewicz, W. Zidek, Y. Chiang and A. Satlin, “Aliskiren, an Orally Effective Renin Inhibitor, Provides Antihypertensive Efficacy Alone and in Combination with Valsartan,” American Journal of Hypertension, Vol. 20, No. 1, 2007, pp. 11-20. doi:10.1016/j.amjhyper.2006.06.003
[25]	A. Villamil, S. G. Chrysant, D. Calhoun, B. Schober, H. Hsu, L. Matrisciano-Dimichino and J. Zhang, “Renin Inhibition with Aliskiren Provides Additive Antihypertensive Efficacy When Used in Combination with Hydrochlorothiazide,” Journal of Hypertension, Vol. 25, No. 1, 2007, pp. 217-226. doi:10.1097/HJH.0b013e3280103a6b
[26]	M. M. Shafiq, D. V. Menon and R. G. Victor, “Oral Direct Renin Inhibition: Premise, Promise, and Potential Limitations of a New Antihypertensive Drug,” The American Journal of Medicine, Vol. 121, No. 4, 2008, pp. 265-271. doi:10.1016/j.amjmed.2007.11.016
[27]	H. H. Parving, F. Persson, J. B. Lewis, E. J. Lewis and N. K. Hollenberg, “AVOID Study Investigators Aliskiren Combined with Losartan in Type 2 Diabetes and Nephropathy,” The New England Journal of Medicine, Vol. 358, No. 23, 2008, pp. 2433-2446. doi:10.1056/NEJMoa0708379
[28]	H. H. Parving, B. M. Brenner, J. J. McMurray, D. de Zeeuw, S. M. Haffner, S. D. Solomon, N. Chaturvedi, M. Ghadanfar, N. Weissbach, Z. Xiang and J. Armbrecht, “Cardiorenal End Points in a Trial of Aliskiren for Type 2 Diabetes,” The New England Journal of Medicine, Vol. 367, 2012, pp. 2204-2213. doi:10.1056/NEJMoa1208799
[29]	M. Azizi and J. Ménard, “Renin Inhibitors and Cardiovascular and Renal Protection: An Endless Quest?” Cardiovascular Drugs and Therapy, 2012.
[30]	Z. Harel, C. Gilbert, R. Wald, C. Bell, J. Perl, D. Juurlink, J. Beyene and P. S. Shah, “The Effect of Combination Treatment with Aliskiren and Blockers of the Renin-Angiotensin System on Hyperkalemia and Acute Kidney Injury: Systematic Review and Meta-Analysis,” British Medical Journal, Vol. 344, 2012, p. e42. doi:10.1136/bmj.e42
[31]	R. T. Gansevoort, W. J. Sluiter, M. H. Hemmelder, D. de Zeeuw and P. E. de Jong, “Antiproteinuric Effect of Blood-Pressure-Lowering Agents: A Meta-Analysis of Comparative Trials,” Nephrology Dialysis Transplantation, Vol. 10, No. 11, 1995, p. 1963.
[32]	A. J. Apperloo, D. de Zeeuw, H. E. Sluiter and P. E. de Jong, “Differential Effects of Enalapril and Atenolol on Proteinuria and Renal Hemodynamics in Non-Diabetic Renal Disease,” British Medical Journal, Vol. 303, No. 6806, 1991, p. 821. doi:10.1136/bmj.303.6806.821
[33]	M. E. Rosenberg and T. H. Hostetter, “Comparative Effects of Antihypertensives on Proteinuria: AngiotensinConverting Enzyme Inhibitor versus Alpha 1-Antagonist,” American Journal of Kidney Diseases, Vol. 18, No. 4, 1991, p. 472.