caa a22 4500 445882743 CHVBK 20180317145549.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s10157-011-0503-4 doi (NATIONALLICENCE)springer-10.1007/s10157-011-0503-4 Safety and efficacy of administering the maximal dose of candesartan in renal transplant recipients [Elektronische Daten] [Masayoshi Okumi, Noritaka Kawada, Naotsugu Ichimaru, Harumi Kitamura, Toyofumi Abe, Ryoichi Imamura, Yasuyuki Kojima, Yukito Kokado, Yoshitaka Isaka, Hiromi Rakugi, Norio Nonomura, Toshiki Moriyama, Shiro Takahara] Background: The regular dose of an angiotensin II type-1 receptor blocker (ARB) in renal transplant patients for hypertension is shown to be safe and effective; however, information on the appropriate dosing of ARBs in renal transplant patients is limited. We evaluate the efficacy and safety of the maximal dose of candesartan administered to renal transplant patients. Methods: Sixty-nine recipients were enrolled in this study. Patients were divided into three groups based on the basal dose of candesartan: patients not taking candesartan (Group A); patients taking a low to medium dose of candesartan (2-4mg/day; Group B); and patients taking a high dose of candesartan (8mg/day; Group C). During the course of the study, the dose of candesartan was gradually increased to a final dose of 12mg/day. Physiological and biochemical parameters were measured before and after the 12-month study period. Results: Ninety-one percent of patients succeeded in continuing their administration of candesartan for 1year and 75% tolerated the administration of the maximal dose of candesartan. Significant differences in proteinuria, albuminuria, serum creatinine, and estimated glomerular filtration rate (eGFR) level among the groups were detected. In Group A, candesartan reduced systolic blood pressure, decreased the levels of proteinuria, albuminuria, eGFR, and hemoglobin and increased plasma potassium, creatinine level, and plasma renin activity. Conclusion: The gradual increase of an ARB to its maximal dose in renal transplant patients is safe when carefully monitored. We were able to demonstrate the impact of maximal renin−angiotensin system (RAS) blockade on both proteinuria and albuminuria, which indicates the need for future, long-term randomized prospective trials to further establish the impact of maximal RAS blockade on renal and cardiovascular protection in transplant patients. Japanese Society of Nephrology, 2011 Anemia nationallicence Hyperkalemia nationallicence Albuminuria nationallicence Okumi Masayoshi Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut Kawada Noritaka Division of Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut Ichimaru Naotsugu Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut Kitamura Harumi Division of Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut Abe Toyofumi Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut Imamura Ryoichi Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut Kojima Yasuyuki Soryukai Inoue Hospital, Suita, Osaka, Japan aut Kokado Yukito Takahashi Clinic, Toyonaka, Osaka, Japan aut Isaka Yoshitaka Division of Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut Rakugi Hiromi Division of Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut Nonomura Norio Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut Moriyama Toshiki Health Care Center, Osaka University, Suita, Osaka, Japan aut Takahara Shiro Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, Suita, Osaka, Japan aut Clinical and Experimental Nephrology Springer Japan 15/6(2011-12-01), 907-915 1342-1751 15:6<907 2011 15 10157 https://doi.org/10.1007/s10157-011-0503-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10157-011-0503-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Okumi Masayoshi Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Kawada Noritaka Division of Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Ichimaru Naotsugu Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Kitamura Harumi Division of Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Abe Toyofumi Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Imamura Ryoichi Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Kojima Yasuyuki Soryukai Inoue Hospital, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Kokado Yukito Takahashi Clinic, Toyonaka, Osaka, Japan aut NATIONALLICENCE 700 1- Isaka Yoshitaka Division of Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Rakugi Hiromi Division of Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Nonomura Norio Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Moriyama Toshiki Health Care Center, Osaka University, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Takahara Shiro Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, Suita, Osaka, Japan aut NATIONALLICENCE 773 0- Clinical and Experimental Nephrology Springer Japan 15/6(2011-12-01), 907-915 1342-1751 15:6<907 2011 15 10157 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer