Journal
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
Volume 5, Issue 7, Pages 1174-1181Publisher
AMER SOC NEPHROLOGY
DOI: 10.2215/CJN.01110210
Keywords
-
Categories
Funding
- Gulhane School of Medicine Research Center
- Center of Gender Medicine at Karolinska Institutet
- Loo and Flans Osterman Foundation
- Swedish Kidney Association
- Ministerio de Ciencia y Tecnologia [SAF 2007/60896, SAF2007/63648]
- Comunidad de Madrid [S2006/GEN-0247]
- Fondo de Investigaciones Sanitarias
- Instituto de Salud Carlos III
- Ministerio de Sanidad y Consumo
- RETICS [RD06/0014/0035]
- Sociedad Espanola de Arteriosclerosis and Fundacion Ramon Areces
Ask authors/readers for more resources
Background and objectives: Soluble TNF-like weak inducer of apoptosis (sTWEAK) and long pentraxin-3 (PTX3) concentrations have been associated with endothelial function in patients with chronic kidney disease (CKD). This study tested the hypothesis that the improvement in endothelial function after initiation of angiotensin II receptor blocker (valsartan), calcium channel blocker (amlodipine) therapy, or a combination of both is directly linked to the normalization of sTWEAK and PTX3. Design, setting, participants, & measurements: One-hundred-eight diabetic CKD stage I patients with hypertension (56% men, 46.7 +/- 5.3 years) were allocated to a 12-week intervention with amlodipine (10 mg/d), valsartan (160 mg/d), or their combination. Plasma levels of sTWEAK, PTX3, and flow-mediated dilation (FMD) were studied during the interventions. Results: All treatment strategies effectively increased FMD and reduced proteinuria, confirming a more prone reduction with the combined therapy. These improvements were followed by significant PTX3 reductions. Valsartan alone and in combination with amlodipine achieved significant incremental raises in sTWEAK plasma levels. More importantly, the changes observed in sTWEAK (beta = 0.25, P = 0.006) or PTX3 (beta = -0.24, P = 0.007) plasma levels were independently associated with the improvement in ultrasonographically measured FMD. Conclusions: This study shows that treatment with antihypertensive drugs improves FMD and normalizes proteinuria, PTX3, and sTWEAK in diabetic CKD stage I patients with hypertension. The improvement in FMD was independently associated with PTX3 and sTWEAK normalization. Two surrogate biomarkers of endothelial function are therefore identified with potential as therapeutic targets. The study was registered in clinicaltrials.gov as NCT00921570. Clin J Am Soc Nephrol 5: 1174-1181, 2010. doi: 10.2215/CJN.01110210
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available