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
- 1Merck Research Laboratories, Merck & Co., Inc., Upper Gwynedd, Pennsylvania
- 2Department of Clinical Nephrology, Columbia University, New York, New York
- 3Division of Endocrinology, Metabolism & Lipid Research, Washington University, St. Louis, Missouri
- 4Department of Medical Endocrinology, University Hospital of Copenhagen, Copenhagen, Denmark
- 5Baker Heart Research Institute, Melbourne, Australia
- 6Renal 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
Abstract
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.
- CKD, chronic kidney disease
- ESRD, end-stage renal disease
- RENAAL, Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan
Footnotes
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Published ahead of print at http//:care.diabetesjournals.org on 10 December 2007. DOI: 10.2337/dc07-0196. Clinical trial registry no. NCT00308347, www.clinicaltrials.gov.
G.B.A. has received speaker honoraria from Merck. J.B.M. has received grant funding from Merck, has served on advisory boards for Merck, and has received honoraria for speaking engagements from Merck. B.M.B. has served on the speakers bureau for and received honoraria from Merck.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.
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- Accepted December 4, 2007.
- Received January 31, 2007.
- DIABETES CARE
