Aliskiren suppresses the renin–angiotensin–aldosterone system and reduces blood pressure and albuminuria in elderly chronic kidney disease patients with hypertension

Figures & data

Figure 1 Patient flow chart.

Abbreviations: CKD, chronic kidney disease; ARB, angiotensin-receptor blockers.

Table 1 Patient baseline characteristics (n = 19)

Parameter	Statistics
Age (years)	74.6 ± 5.8 (65.0–84.7)
Sex
Male	9
Female	10
BMI (kg/m^2)	25.4 ± 6.0
CKD
Stage 1	1
Stage 2	9
Stage 3	3
Stage 4	3
Stage 5	3
SBP (mmHg)	153.6 ±14.9
DBP (mmHg)	77.2 ± 10.4
HR (beats/minute)	63.3 ± 10.6
Creatinine (mg/dL)	1.4 ± 1.0
eGFR (mL/minute/1.73 m^2)	52.1 ± 29.2
UACR (mg/g)	747.1 ± 1121.4
PRA (ng/mL/hour)	1.3 ± 1.0
Ang 1 (pg/mL)	59.5 ± 32.1
Ang 2 (pg/mL)	58.4 ± 62.1
Ald (pg/mL)	86.1 ± 38.3
BNP (pg/mL)	48.2 ± 46.0
LVEF (%)	66.8 ± 7.9
IVST (mm)	10.1 ± 1.8
LVPWT (mm)	10.0 ± 1.6

Abbreviations: BMI, body mass index; CKD, chronic kidney disease; SBP, systolic blood pressure; DBP, diastolic blood pressure; HR, heart rate; egFR, estimated glomerular filtration rate; UACR, urinary albumin/creatinine ratio; PRA, plasma renin activity; Ang 1, angiotensin I; Ang 2, angiotensin II; Ald, aldosterone; BNP, brain natriuretic peptide; LVEF, left ventricular ejection fraction; IVST, interventricular septum thickness; LVPWT, left ventricular posterior wall thickness.

Table 2 Patient clinical characteristics before aliskiren treatment

No	CKD stage	eGFR (mL/minute/1.73 m^2)	Sex	Age (years)	Antihypertensives (day)	SBP (mmHg)	DBP (mmHg)
1	1	105.6	Male	71.6	Amlodipine 5 mg Telmisartan 40 mg	203	83
2	2	89.6	Female	72.8	Olmesartan 20 mg Amlodipine 5 mg	157	61
3	2	82.8	Male	68.3	Olmesartan 40 mg Azelnidipine 16 mg Doxazosin 2 mg	162	84
4	2	78.0	Male	84.4	Olmesartan 20 mg Torasemide 4 mg Azelnidipine 16 mg	160	78
5	2	74.0	Female	75.7	Azelnidipine 16 mg Valsartan 80 mg Trichlormethiazide 1 mg	140	80
6	2	71.3	Female	75.3	Olmesartan 20 mg Azelnidipine 16 mg	150	70
7	2	70.3	Female	84.9	Olmesartan 20 mg Ateolol 50 mg Azelnidipine 16 mg	151	60
8	2	64.8	Female	73.3	Azelnidipine 16 mg Olmesartan 20 mg Doxazosin 2 mg Furosemide 20 mg	154	71
9	2	60.9	Female	73.5	Amlodipine 5 mg Doxazosin 2 mg	141	73
10	2	60.8	Male	84.7	Olmesartan 20 mg Amlodipine 5 mg Carvedilol 5 mg	159	76
11	3	54.4	Male	72.0	Amlodipine 5 mg Temocapril 4 mg Doxazosin 2 mg	155	99
12	3	42.7	Female	64.9	Telmisartan 40 mg Amlodipine 5 mg	140	76
13	3	32.8	Female	76.2	Candesartan 4 mg Benidipine 4 mg	143	68
14	4	24.1	Male	73.5	Amlodipine 10 mg Candesartan 8 mg	156	94
15	4	19.8	Female	76	Azelnidipine 8 mg Azelnidipine 16 mg	140	70
16	4	18.6	Male	65.9	Nifedipine 40 mg Olmesartan 20 mg Doxazosin 8 mg Temocapril 4 mg Carvedilol 5 mg Furosemide 60 mg	141	86
17	5	14.5	Female	73	Amlodipine 5 mg Candesartan 8 mg	148	70
18	5	12.3	Male	81.1	Cilndipine 20 mg Doxazosin 2 mg Telmisartan 10 mg	147	78
19	5	12.0	Male	70.4	Amlodipine 5 mg Olmesartan 20 mg	171	90

Abbreviations: CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; SBP, systolic blood pressure; DBP, diastolic blood pressure.

Figure 2 Changes in plasma renin activity (PRA), angiotensin I (Ang I), angiotensin II (Ang II) and aldosterone (Ald) upon aliskiren treatment.

Abbreviation: NS, not significant.

Figure 3 Changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) from baseline to week 24.

Note: *P < 0.05 compared with the value at baseline.

Figure 4 Changes in urine albumin/creatinine ratio (UACR) (all patients: n = 19), UACR with microalbuminuria (n = 7), and UACR with macroalbuminuria (n = 9) (A), and estimated glomerular filtration ratio (eGFR) (B) upon aliskiren treatment.

Abbreviation: NS, not significant.

Figure 5 Changes in left ventricular ejection fraction (LVEF) (A) and plasma brain natriuretic peptide (BNP) level (B) upon aliskiren treatment.

Abbreviation: NS, not significant.