Cooperate clinical trial

Introduction

Japanese randomized controlled trial.

Designed to test maximum dose:

• ACE inhibitor
• angiotensin 2 receptor antagonist (ARB)
• 1 & 2 (combined therapy)

in non-diabetic renal disease.

263 patients

serum creatinine 1.5-4.5 mg/dL

glomerular filtration rate 20-70 mL/min/m2

Most patients had treated hypertension.

Mean blood pressure 130/75 on therapy other than ACE inhibitor or ARB

Mean follow-up: 2.9 years

Combined endpoints:

• doubling of serum creatinine, or
• end stage renal disease (ESRD)

Results:

• end point lowest in combined therapy group (11%)
• 23% in ACE inhibitor or ARB alone
• other associations with lower incidence of endpoint
  • larger reductions in proteinuria
  • use of diuretic
• similar reductions in blood pressure (BP) in 3 groups 5 mm systolic BP; 3 mm diastolic BP
• no difference in adverse effects

More general terms

• clinical trial
• hypertension clinical trials