Related Experiment Video

Updated: Aug 4, 2026

A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis
08:21

A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis

Published on: October 26, 2020

Renoprotection with and without blood pressure reduction

Gozewijn Dirk Laverman1, Steen Andersen, Peter Rossing

  • 1Division of Nephrology, Department of Internal Medicine, and Department of Clinical Pharmacology, University of Groningen, Groningen, The Netherlands. gd_laverman@hotmail.com

Kidney International. Supplement
|March 9, 2005
PubMed

Insights

Losartan effectively reduces albuminuria in patients with type 1 diabetes and non-diabetic kidney disease. Optimal albuminuria reduction may require higher losartan doses than those needed for blood pressure control.

Area of Science:

  • Nephrology
  • Pharmacology
  • Cardiology

Background:

  • Angiotensin II receptor (AT1) blockade lowers blood pressure (BP) and albuminuria.
  • Both BP and albuminuria reduction are independent renoprotective targets.
  • The optimal dosing strategy for achieving both targets is not well-defined.

Purpose of the Study:

  • To determine the optimal dose of losartan for reducing albuminuria.
  • To investigate if BP response influences albuminuria reduction.
  • To assess if higher losartan doses are needed for maximal albuminuria reduction.

Main Methods:

  • Two studies were conducted in type 1 diabetic (DM) and non-diabetic (ND) renal patients.
  • Patients received escalating doses of losartan (50, 100, 150 mg/day).
  • BP and 24-hour albuminuria were measured at each dose; patients were categorized by BP response.

Main Results:

  • Losartan reduced albuminuria dose-dependently in both good and poor BP responders.
  • Patients with poor BP response still showed significant albuminuria reduction.
  • Albuminuria continued to decrease with higher losartan doses, even after BP targets were met.

Conclusions:

  • A lack of significant BP response to losartan does not prevent albuminuria reduction.
  • Maximal albuminuria reduction may necessitate losartan dosing beyond that required for optimal BP control.
  • Individualized dose titration is crucial for achieving renoprotective goals.
Abstract

More Related Videos

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion08:35

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

Published on: May 26, 2022

Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension04:37

Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension

Published on: June 6, 2025

Related Concept Videos

Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
Antihypertensive Drugs: Action of Diuretics01:16

Antihypertensive Drugs: Action of Diuretics

Diuretics are antihypertensive drugs used to treat hypertension resulting from sodium and water retention. Sodium, vital for fluid balance and nerve or muscle function, is regulated by the kidneys through millions of nephrons. Blood enters nephrons via afferent arterioles, which branch into capillaries called glomeruli. These filter blood plasma, allowing water and solutes, like sodium ions, to pass through capillary walls into Bowman's capsule. The filtrate then flows through various tubules...
Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors01:30

Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors

Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
Antihypertensive Drugs: Direct Renin Inhibitors01:25

Antihypertensive Drugs: Direct Renin Inhibitors

The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Hypertension IV: Drug Therapy and Lifestyle Modifications01:28

Hypertension IV: Drug Therapy and Lifestyle Modifications

Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...