Effects of telmisartan and candesartan on the metabolism of lipids and glucose in kidney transplant patients: A prospective, randomized crossover study

Yoshifumi Miura, Hiroshi Noguchi, Yasuhiro Okabe, Kosuke Masutani, Shoji Tokunaga, Masafumi Nakamura

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Abstract

Background. The risk of cardiovascular events remains after kidney transplantation (KT). Abnormal glucose metabolism and hyperlipidemia contribute partly to this risk. Among angiotensin II type-1 receptor blockers, telmisartan alone has been shown to ameliorate these effects on glucose and lipid metabolism (GLM). We investigated the effects of telmisartan on GLM in KT patients. Methods. This trial had a crossover design. Forty-six KT patients with well-controlled hypertension under angiotensin II type-1 receptor blockers were randomized into telmisartan and candesartan groups. After a 12-week treatment, crossover was initiated, and additional 12-week treatment was administered without a washout period. We examined the laboratory parameters of GLM, blood pressure and graft function before and after each treatment period. Results. Forty patients completed the scheduled treatment regimen. Serum levels of triglyceride were significantly lower (114.3 ± 50.8 mg/dL vs 136.5 ± 66.8 mg/dL; P = 0.019), and the estimated glomerular filtration rate was significantly higher (50.4 ± 15.1 mL/min per 1.73 m 2 vs 48.5 ± 12.5 mL/min per 1.73 m 2 ; P = 0.038) after telmisartan treatment than after candesartan treatment. There were no significant differences between the 2 treatment groups with regard to the other parameters studied (including serum adiponectin levels and parameters of glucose metabolism). Conclusions. These data suggest that telmisartan can improve serum triglyceride levels and graft function for KT patients better than candesartan.

Original languageEnglish
Article numbere423
JournalTransplantation Direct
Volume5
Issue number2
DOIs
Publication statusPublished - Feb 1 2019

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Lipid Metabolism
Cross-Over Studies
Transplants
Kidney
Glucose
Kidney Transplantation
Angiotensin II Type 1 Receptor Blockers
Therapeutics
Triglycerides
Serum
Adiponectin
candesartan
telmisartan
Hyperlipidemias
Glomerular Filtration Rate
Blood Pressure
Hypertension

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

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title = "Effects of telmisartan and candesartan on the metabolism of lipids and glucose in kidney transplant patients: A prospective, randomized crossover study",
abstract = "Background. The risk of cardiovascular events remains after kidney transplantation (KT). Abnormal glucose metabolism and hyperlipidemia contribute partly to this risk. Among angiotensin II type-1 receptor blockers, telmisartan alone has been shown to ameliorate these effects on glucose and lipid metabolism (GLM). We investigated the effects of telmisartan on GLM in KT patients. Methods. This trial had a crossover design. Forty-six KT patients with well-controlled hypertension under angiotensin II type-1 receptor blockers were randomized into telmisartan and candesartan groups. After a 12-week treatment, crossover was initiated, and additional 12-week treatment was administered without a washout period. We examined the laboratory parameters of GLM, blood pressure and graft function before and after each treatment period. Results. Forty patients completed the scheduled treatment regimen. Serum levels of triglyceride were significantly lower (114.3 ± 50.8 mg/dL vs 136.5 ± 66.8 mg/dL; P = 0.019), and the estimated glomerular filtration rate was significantly higher (50.4 ± 15.1 mL/min per 1.73 m 2 vs 48.5 ± 12.5 mL/min per 1.73 m 2 ; P = 0.038) after telmisartan treatment than after candesartan treatment. There were no significant differences between the 2 treatment groups with regard to the other parameters studied (including serum adiponectin levels and parameters of glucose metabolism). Conclusions. These data suggest that telmisartan can improve serum triglyceride levels and graft function for KT patients better than candesartan.",
author = "Yoshifumi Miura and Hiroshi Noguchi and Yasuhiro Okabe and Kosuke Masutani and Shoji Tokunaga and Masafumi Nakamura",
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T1 - Effects of telmisartan and candesartan on the metabolism of lipids and glucose in kidney transplant patients

T2 - A prospective, randomized crossover study

AU - Miura, Yoshifumi

AU - Noguchi, Hiroshi

AU - Okabe, Yasuhiro

AU - Masutani, Kosuke

AU - Tokunaga, Shoji

AU - Nakamura, Masafumi

PY - 2019/2/1

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N2 - Background. The risk of cardiovascular events remains after kidney transplantation (KT). Abnormal glucose metabolism and hyperlipidemia contribute partly to this risk. Among angiotensin II type-1 receptor blockers, telmisartan alone has been shown to ameliorate these effects on glucose and lipid metabolism (GLM). We investigated the effects of telmisartan on GLM in KT patients. Methods. This trial had a crossover design. Forty-six KT patients with well-controlled hypertension under angiotensin II type-1 receptor blockers were randomized into telmisartan and candesartan groups. After a 12-week treatment, crossover was initiated, and additional 12-week treatment was administered without a washout period. We examined the laboratory parameters of GLM, blood pressure and graft function before and after each treatment period. Results. Forty patients completed the scheduled treatment regimen. Serum levels of triglyceride were significantly lower (114.3 ± 50.8 mg/dL vs 136.5 ± 66.8 mg/dL; P = 0.019), and the estimated glomerular filtration rate was significantly higher (50.4 ± 15.1 mL/min per 1.73 m 2 vs 48.5 ± 12.5 mL/min per 1.73 m 2 ; P = 0.038) after telmisartan treatment than after candesartan treatment. There were no significant differences between the 2 treatment groups with regard to the other parameters studied (including serum adiponectin levels and parameters of glucose metabolism). Conclusions. These data suggest that telmisartan can improve serum triglyceride levels and graft function for KT patients better than candesartan.

AB - Background. The risk of cardiovascular events remains after kidney transplantation (KT). Abnormal glucose metabolism and hyperlipidemia contribute partly to this risk. Among angiotensin II type-1 receptor blockers, telmisartan alone has been shown to ameliorate these effects on glucose and lipid metabolism (GLM). We investigated the effects of telmisartan on GLM in KT patients. Methods. This trial had a crossover design. Forty-six KT patients with well-controlled hypertension under angiotensin II type-1 receptor blockers were randomized into telmisartan and candesartan groups. After a 12-week treatment, crossover was initiated, and additional 12-week treatment was administered without a washout period. We examined the laboratory parameters of GLM, blood pressure and graft function before and after each treatment period. Results. Forty patients completed the scheduled treatment regimen. Serum levels of triglyceride were significantly lower (114.3 ± 50.8 mg/dL vs 136.5 ± 66.8 mg/dL; P = 0.019), and the estimated glomerular filtration rate was significantly higher (50.4 ± 15.1 mL/min per 1.73 m 2 vs 48.5 ± 12.5 mL/min per 1.73 m 2 ; P = 0.038) after telmisartan treatment than after candesartan treatment. There were no significant differences between the 2 treatment groups with regard to the other parameters studied (including serum adiponectin levels and parameters of glucose metabolism). Conclusions. These data suggest that telmisartan can improve serum triglyceride levels and graft function for KT patients better than candesartan.

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