Angiotensin II Blockade in Kidney Transplant Recipients

• DOI: 10.1681/asn.2012080777
• Publication Date: 2013-01-11T05:47:57Z
• Authors: Hassan N. Ibrahim; Scott Jackson; Jeffery Connaire; Arthur Matas; Arthur Ney; Behzad Najafian; Ann West; Nicole Lentsch; Jensina Ericksen; Jenny Bodner; Bertram Kasiske; Michael Mauer
• Keywords: Clinical endpoint

Interstitial fibrosis/tubular atrophy (IF/TA) contributes to the loss of kidney allografts, and treatment or preventive options are lacking. We conducted a double-blind, randomized, placebo-controlled trial determine whether angiotensin II blockade prevents expansion cortical interstitial compartment, precursor fibrosis. randomly assigned 153 transplant recipients receive losartan, 100 mg (n=77), matching placebo (n=76) within 3 months transplantation, continuing for 5 years. The primary outcome was composite doubling fraction renal volume occupied by interstitium from baseline years ESRD IF/TA. In intention-to-treat analysis, using only patients with adequate structural data, endpoint occurred in 6 47 who received losartan 12 44 (odds ratio [OR], 0.39; 95% confidence interval [CI], 0.13-1.15; P=0.08). found no significant effect on time ESRD, death, creatinine level. secondary seemed reduce risk all-cause (OR, 0.36; CI, 0.13-0.99; P=0.05), but this finding requires validation. conclusion, did not lead statistically reduction IF/TA recipients.