کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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3885797 | 1249524 | 2008 | 7 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: The effect of losartan on hemoglobin concentration and renal outcome in diabetic nephropathy of type 2 diabetes The effect of losartan on hemoglobin concentration and renal outcome in diabetic nephropathy of type 2 diabetes](/preview/png/3885797.png)
Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers can decrease hemoglobin, causing anemia and this may be an independent risk factor for chronic kidney disease progression. We studied the relationship between a decline in hemoglobin and outcome in 1513 patients with type 2 diabetes and kidney disease by a post hoc analysis of the RENAAL Study (Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan) with an average follow-up of 3.4 years. The relationship between baseline and year-1 hemoglobin and treatment on end-stage renal disease (ESRD) and ESRD or death was evaluated using multivariate Cox models (covariates: baseline hemoglobin, proteinuria, serum albumin, serum creatinine, and year-1 hemoglobin). Compared with placebo, losartan treatment was associated with a significant decrease of hemoglobin, with the largest between-group difference at 1 year. After adjustment, there were significant relative risk reductions for losartan compared with placebo for ESRD and for ESRD or death regardless of the baseline hemoglobin even in those patients with a baseline hemoglobin below 120 g l−1. Hence, the renoprotective properties of losartan were maintained despite a significant lowering of the hemoglobin concentration.
Journal: Kidney International - Volume 73, Issue 5, 1 March 2008, Pages 630–636