Changes in Urinary Albumin Excretion, Inflammatory and Oxidative Stress Markers in ADPKD Patients with Hypertension

• Published in: The American journal of the medical sciences Vol. 343; no. 1; pp. 46 - 51
• Main Authors: Nakamura, Tsukasa, MD, Sato, Eiichi, MD, Fujiwara, Nobuharu, MD, Kawagoe, Yasuhiro, MD, Yamada, Shingo, PhD, Ueda, Yoshihiko, MD, Koide, Hikaru, MD
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Elsevier Inc 2012; Lippincott Williams & Wilkins
• Subjects: 8-Hydroxydeoxyguanosine; Aged; Albuminuria - complications; Albuminuria - drug therapy; Albuminuria - metabolism; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Arterial hypertension. Arterial hypotension; Autosomal dominant polycystic kidney; Benzimidazoles - therapeutic use; Benzoates - therapeutic use; Biological and medical sciences; Biomarkers - blood; Biomarkers - urine; Blood and lymphatic vessels; Cardiology. Vascular system; Creatinine - blood; Deoxyguanosine - analogs & derivatives; Deoxyguanosine - urine; Enalapril; Enalapril - therapeutic use; Female; General aspects; High mobility group box-1 protein; HMGB1 Protein - blood; Humans; Hypertension - complications; Hypertension - drug therapy; Hypertension - metabolism; Hypertension - urine; Inflammation - blood; Inflammation - etiology; Interleukin-6 - blood; Internal Medicine; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Oxidative Stress; Polycystic Kidney, Autosomal Dominant - complications; Polycystic Kidney, Autosomal Dominant - drug therapy; Polycystic Kidney, Autosomal Dominant - metabolism; Polycystic Kidney, Autosomal Dominant - urine; Telmisartan; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; Enalapril; High mobility group box-1 protein; Autosomal dominant polycystic kidney; 8-Hydroxydeoxyguanosine; Telmisartan; Imidazole derivatives; Oxidative stress; Peptide hormone; Biological marker; Cardiovascular disease; Octapeptide; Peptidyl-dipeptidase A; Cyst; Benign neoplasm; Angiotensin II; Kidney disease; Human; Hypertension; Urine; Excretion; Urinary system disease; Enzyme; Polycystic kidney; HMGB1 Protein; Enzyme inhibitor; Albumin; Biological indicator; Patient; Autosome; Inflammation; Change; Genetic disease; Medicine; Peptidases; Renin angiotensin system; Benzimidazole derivatives; Hydrolases; Peptidyl-dipeptidases; Antihypertensive agent; Sartan derivatives; Angiotensin antagonist; Inheritance(genetics); ACE inhibitor; Proteinuria
• ISSN: 0002-9629; 1538-2990
• DOI: 10.1097/MAJ.0b013e31821f0552

Abstract Backgrounds Autosomal dominant polycystic kidney disease (ADPKD) progresses more quickly to end-stage renal disease in patients with hypertension than in their normotensive counterparts. The authors investigated the effect of telmisartan versus enalapril on systolic and diastolic blood pressure (SBP and DBP), urinary albumin excretion (UAE), serum high mobility group box-1 protein (HMGB1), serum interleukin (IL)-6 and urinary 8-hydroxydeoxyguanosine (8-OHdG) levels in patients with hypertensive ADPKD. Methods Twenty patients with hypertensive ADPKD with good renal function were randomly assigned to 1 of 2 treatments: telmisartan 80 mg once daily (n = 10) or enalapril 10 mg once daily (n = 10). Treatment lasted 12 months. SBP, DBP, serum creatinine, UAE, HMGB1, IL-6 and urinary 8-OHdG levels were measured before and 6 and 12 months after treatment. Results Both SBP and DBP were significantly reduced after treatment ( P < 0.001) in both groups. Serum creatinine changed little during the experimental period in either group. UAE, serum HMGB1, serum IL-6 and urinary 8-OHdG levels were significantly decreased after treatment (UAE, HMGB1 and IL-6, P < 0.001; and 8-OHdG, P < 0.01 versus baseline levels) in both groups. However, the decreases in UAE, serum HMGB1 and serum IL-6 were significantly greater in the telmisartan group than in the enalapril group at 6 months ( P < 0.05, P < 0.01 and P < 0.01, respectively) and 12 months (all, P < 0.05). Conclusions Telmisartan seems to be equivalent to enalapril in lowering BP, but telmisartan has more potent renoprotective, anti-inflammatory and antioxidative effects than enalapril in patients with hypertensive ADPKD.