Aim: To evaluate the proteinuria-lowering effect of a renin inhibitor (aliskiren), compared to placebo and to an angiotensin-converting enzyme inhibitor (perindopril), in patients with non-diabetic chronic kidney disease. Methods: A randomised, double-blind, crossover trial was performed in 14 patients with nondiabetic chronic kidney disease with 24-h mean proteinuria of 2.01 g (95% CI, 1.36-2.66) and estimated creatinine clearance of 93 ± 6.8 ml/min. The study consisted of five treatment periods. The patients were randomly assigned to receive aliskiren (150 mg), aliskiren (300 mg), perindopril (5 mg), perindopril (10 mg) or placebo. Results: Aliskiren and perindopril reduced proteinuria. These effects were dose-dependent. Furthermore, 24-h proteinuria was reduced by 23% (mean 95% CI; 2-44) by treatment with aliskiren (150 mg), by 36% (95% CI, 17-55; P < 0.001) with aliskiren (300 mg), by 7.1% (95% CI, 11-26) with perindopril (5 mg) and by 25% (95% CI, 11-39; P < 0.05) with perindopril (10 mg), compared to placebo. No significant difference was found between the effects of aliskiren and perindopril. Conclusions: Aliskiren significantly reduced proteinuria. The antiproteinuric effect is probably similar to that of perindopril, for equivalent hypotensive dosages. The renin inhibitor provides a promising alternative approach for the treatment of patients with chronic proteinuric non-diabetic kidney disease. © 2012 The Author(s).
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Lizakowski, S., Tylicki, L., Renke, M., Rutkowski, P., Heleniak, Z., Sławińska-Morawska, M., … Rutkowski, B. (2012). Effect of aliskiren on proteinuria in non-diabetic chronic kidney disease: A double-blind, crossover, randomised, controlled trial. International Urology and Nephrology, 44(6), 1763–1770. https://doi.org/10.1007/s11255-011-0110-z