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Published online December 10, 2007
Diabetes Care 31:445-447, 2008
DOI: 10.2337/dc07-0196
© 2008 by the American Diabetes Association
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Clinical Care/Education/Nutrition/Psychosocial Research
Original Research

Effect of LDL Cholesterol and Treatment With Losartan on End-Stage Renal Disease in the RENAAL Study

Andrew M. Tershakovec, MD1, William F. Keane, MD1, Zhongxin Zhang, PHD1, Paulette A. Lyle, BS1, Gerald B. Appel, MD2, Janet B. McGill, MD3, Hans-Henrik Parving, MD4, Mark E. Cooper, MD, PHD5, Shahnaz Shahinfar, MD1 and Barry M. Brenner, MD6

1 Merck Research Laboratories, Merck & Co., Inc., Upper Gwynedd, Pennsylvania
2 Department of Clinical Nephrology, Columbia University, New York, New York
3 Division of Endocrinology, Metabolism & Lipid Research, Washington University, St. Louis, Missouri
4 Department of Medical Endocrinology, University Hospital of Copenhagen, Copenhagen, Denmark
5 Baker Heart Research Institute, Melbourne, Australia
6 Renal Division, Brigham and Women's Hospital, Boston, Massachusetts

Address correspondence and reprint requests to Andrew M. Tershakovec, Merck & Co., Inc., 351 N. Sumneytown Pike, North Wales, PA 19454. E-mail: andrew_tershakovec{at}merck.com

Renal pathology and dyslipidemia commonly coexist. Treatments that lower albuminuria/proteinuria may lower lipids, but it is not known whether lipid lowering independent of lessening albuminuria/proteinuria slows progression of kidney disease. We examined the association between LDL cholesterol levels and treatment with losartan on end-stage renal disease (ESRD). Lipid levels and albuminuria measurements were obtained at baseline and at year 1 in a post hoc analysis from the Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan (RENAAL) study, which compared the effects of losartan- versus placebo-based antihypertensive therapy in patients with type 2 diabetes and nephropathy. LDL cholesterol lowering was associated with a lower risk of ESRD; however, this seemed to be largely an association with the reduction in albuminuria.

Abbreviations: CKD, chronic kidney disease • ESRD, end-stage renal disease • RENAAL, Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan


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