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Published on: May 26, 2022
Long-term renoprotective effect of candesartan in renal transplant patients
1Department of Urology, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, Japan.
Insights
Long-term use of candesartan cilexetil is safe and effective for protecting kidney transplant recipients. This angiotensin II type 1 receptor blocker (ARB) helps manage blood pressure and reduce proteinuria, preserving renal graft function.
Area of Science:
- Nephrology
- Pharmacology
- Transplantation
Background:
- Angiotensin II type 1 receptor blockers (ARBs) show renoprotective effects, but long-term data in renal transplant patients are limited.
- Assessing the safety and efficacy of long-term candesartan cilexetil treatment is crucial for graft function preservation.
Purpose of the Study:
- To evaluate the long-term safety and effectiveness of candesartan cilexetil in protecting renal graft function.
- To analyze changes in blood pressure, urine protein, and estimated glomerular filtration rate (eGFR) under sustained ARB treatment.
Main Methods:
- A study involving 41 renal transplant patients with proteinuria and hypertension treated with candesartan cilexetil for up to 9 years (mean 4.8 years).
- Concomitant use of immunosuppressants (cyclosporine or tacrolimus) and other antihypertensives was noted.
- Baseline serum creatinine was 1.51 ± 0.53 mg/dL.
Main Results:
- Significant reductions in systolic and diastolic blood pressure were observed, with targets met by 56.1% and 68.3% of patients, respectively.
- No significant changes in serum creatinine levels or eGFR were detected, indicating stable renal function.
- Urinary protein levels decreased significantly, becoming negative or marginal in 63.4% of subjects.
Conclusions:
- Candesartan cilexetil demonstrates safety for long-term use in renal transplant recipients.
- The medication effectively protects renal graft function by managing blood pressure and reducing proteinuria.
Background:
The renoprotective effects of angiotensin II type 1 receptor blockers (ARBs) have been demonstrated in a number of clinical studies, but there are few evaluations of long-term ARB treatment. We measured blood pressure, urine protein, and estimated glomerular filtration rate (eGFR) among patients under long-term (up to 9 years) treatment with candesartan cilexetil to evaluate its safety and effectiveness to protect renal graft function.
Methods:
This study of 41 patients (31 male and 10 female) who presented with proteinuria and hypertension (blood pressure >140/90 mm Hg) after receiving a renal graft. Their serum creatinine level at baseline was 1.51 ± 0.53 mg/dL. Cyclosporine or tacrolimus were concomitantly prescribed for 18 (43.9%) and 22 (53.7%) subjects, respectively. The ARB treatment period was ≥12 months (up to 9 years, mean 4.8 years). Combination with other antihypertensive drugs (calcium antagonists) was necessary in 14/41 subjects (34.1%).
Results:
Significant declines in blood pressure were observed during the treatment period; blood pressure reduction target (blood pressure <130/80 mm Hg) was met in 56.1% for systolic and 68.3% for diastolic pressure. No significant increase in serum creatinine level or eGFR was observed. Urinary protein was reduced to negative or marginal in 63.4% of the subjects, demonstrating a significant decrease.
Conclusions:
Candesartan cilexetil was considered to be safe even for long-term treatment in renal transplant patients, and effective to protect renal graft function.
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