COMPARISON OF EFFICACY IN RENOPROTECTION BETWEEN AZILSARTAN AND ENALAPRIL: A RANDOMIZED CONTROLLED TRIAL

Background: Angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) are reported to improve renal outcomes among patients with hypertension and chronic kidney disease (CKD), but there might be substantial differences in their renoprotective effects. Azilsartan medoxomil is a relatively new available ARB, highly specific angiotensin type 1 receptor superior terms of blood pressure reduction, respect other ARBs.
 Methods: The study employed randomized controlled trial; hypertensive subjects albuminuria >30 mg/g creatinine at the outpatient clinic, Phramongkutklao Hospital, Bangkok, Thailand were randomly assigned azilsartan 40-80 mg/day (n=27) enalapril 10-40 (n=23) for 24 weeks. primary outcome was change urine albumin ratio (UACR). UACR, estimated glomerular filtration rate (GFR), serum electrolytes evaluated baseline, 12 weeks.
 Results: A total 50 recruited. At end treatment, systolic level significantly reduced group compared (-12.2 mmHg [95%CI -18.9 -5.5] vs. -1.1 [95% -7.8 5.7], p=0.021). In addition, weeks, median UACR observed that (-59.9 Cr CI -284.6 -31.0] -40.4 mg/gCr -129.4 88.3], p=0.026)). No statistically significant difference found between two groups hyperkalemia, GFR, acute injury serious adverse events.
 Conclusion: This demonstrated had antihypertensive albuminuric efficacy standard dose without increasing events.