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Vol. 101, No. 3, 2005
Issue release date: November 2005
Section title: Original Paper
Nephron Clin Pract 2005;101:c139–c149
(DOI:10.1159/000086714)

A Prospective Open-Label Randomised Trial of Quinapril and/or Amlodipine in Progressive Non-Diabetic Renal Failure

MacGregor M.S.a, b · Deighan C.J.a · Rodger R.S.C.b · Boulton-Jones J.M.a
aRenal Unit, Glasgow Royal Infirmary and bRenal Unit, Western Infirmary, Glasgow, Scotland

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 7/2/2004
Accepted: 4/18/2005
Published online: 7/6/2005
Issue release date: November 2005

Number of Print Pages: 1
Number of Figures: 4
Number of Tables: 3

ISSN: (Print)
eISSN: 1660-2110 (Online)

For additional information: http://www.karger.com/NEC

Abstract

Background: Treatment of hypertension slows the progression of non-diabetic nephropathies, but the optimal regimen is unknown. Angiotensin-converting enzyme inhibitors are more effective than β-blockers, but their merits relative to calcium channel blockers are less clear. Methods: 73 hypertensive patients with progressive non-diabetic nephropathies were prospectively randomised to open-label quinapril (Q, n = 28), amlodipine (A, n = 28) or both drugs (Q&A, n = 17). Therapy was increased to achieve a diastolic blood pressure <90 mm Hg. Patients were followed for 4 years or until death. The primary outcome was the combined endpoint of doubling serum creatinine, starting renal replacement therapy or death. Results: There was no significant difference in the primary outcome, or in the change of glomerular filtration rate. Blood pressure was equally controlled throughout the study period. 29 (40%) patients were withdrawn from the allocated therapy (Q 39%, A 36%, Q&A 47%). Because of the large crossover between trial arms, the data were re-analysed per protocol. The effect on preventing the need for renal replacement therapy then approached significance between the groups (p = 0.089) and the combined quinapril-containing groups were less likely than the amlodipine group to achieve the primary endpoint (p = 0.038), or the individual endpoints of renal replacement therapy (p = 0.030) or doubling creatinine (p = 0.051). Conclusions: Quinapril is more effective than amlodipine at reducing the incidence of dialysis in patients with progressive renal failure, but only if they can tolerate the drug. The tolerability of these drugs in patients with advanced renal failure is poor.

© 2005 S. Karger AG, Basel


  

Author Contacts

Dr. Mark S. MacGregor
The John Stevenson Lynch Renal Unit
Crosshouse Hospital, Kilmarnock KA2 0BE (UK)
Tel. +44 1563 577496, Fax +44 1563 577493
E-Mail Mark.MacGregor@aaaht.scot.nhs.uk

  

Article Information

Received: July 2, 2004
Accepted: April 18, 2005
Published online: July 5, 2005
Number of Print Pages : 11
Number of Figures : 4, Number of Tables : 3, Number of References : 39

  

Publication Details

Nephron Clinical Practice

Vol. 101, No. 3, Year 2005 (Cover Date: November 2005)

Journal Editor: Powis, S.H. (London)
ISSN: 1660–2110 (print), 1660–2110 (Online)

For additional information: http://www.karger.com/nec


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 7/2/2004
Accepted: 4/18/2005
Published online: 7/6/2005
Issue release date: November 2005

Number of Print Pages: 1
Number of Figures: 4
Number of Tables: 3

ISSN: (Print)
eISSN: 1660-2110 (Online)

For additional information: http://www.karger.com/NEC


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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