Trial reportBritish journal of clinical pharmacology2015
The renal protective effect of angiotensin receptor blockers depends on intra-individual response variation in multiple risk markers.
Trial report in British journal of clinical pharmacology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 40 citations in OpenAlex.
- Association between Complete Proteinuria Remission and Kidney Function in the Phase 3 PROTECT Trial of Sparsentan in IgA Nephropathy.Clinical journal of the American Society of Nephrology : CJASN · 2026Trial
- Prediction and validation of exenatide risk marker effects on progression of renal disease: Insights from EXSCEL.Diabetes, obesity & metabolism · 2020Trial
- Early Proteinuria Lowering by Angiotensin-Converting Enzyme Inhibition Predicts Renal Survival in Children with CKD.Journal of the American Society of Nephrology : JASN · 2018Trial
- Dapagliflozin reduces albuminuria in patients with diabetes and hypertension receiving renin-angiotensin blockers.Diabetes, obesity & metabolism · 2016Trial
- Prediction of the effect of atrasentan on renal and heart failure outcomes based on short-term changes in multiple risk markers.European journal of preventive cardiology · 2016Trial
- Emerging Urinary Biomarkers and Innovative Technologies for the Early Detection and Personalized Management of Chronic Kidney Disease.International journal of molecular sciences · 2026Review
- Perspectives on Chronic Kidney Disease With Type 2 Diabetes and Risk Management: Practical Viewpoints and a Paradigm Shift Using a Pillar Approach.Clinical diabetes : a publication of the American Diabetes Association · 2023Article
- Studying Telmisartan Plasma Exposure, Kidney Distribution, Receptor Occupancy, and Response in Patients With Type 2 Diabetes Using [Clinical pharmacology and therapeutics · 2022Article
- Up-Date on Diabetic Nephropathy.Life (Basel, Switzerland) · 2022Review
- Precision Nephrology in Patients with Diabetes and Chronic Kidney Disease.International journal of molecular sciences · 2022Review
- Prediction of the Effects of Liraglutide on Kidney and Cardiovascular Outcomes Based on Short-Term Changes in Multiple Risk Markers.Frontiers in pharmacology · 2022Article
- OMICS in Chronic Kidney Disease: Focus on Prognosis and Prediction.International journal of molecular sciences · 2021Review
- Diminished antiproteinuric effect of the angiotensin receptor blocker losartan during high potassium intake in patients with CKD.Clinical kidney journal · 2021Article
- The effect of initiation of renin-angiotensin system inhibitors on haemoglobin: A national cohort study.British journal of clinical pharmacology · 2021Article
- Prediction of the Effects of Empagliflozin on Cardiovascular and Kidney Outcomes Based on Short-Term Changes in Multiple Risk Markers.Frontiers in pharmacology · 2021Article
- A novel drug response score more accurately predicts renoprotective drug effects than existing renal risk scores.Therapeutic advances in endocrinology and metabolism · 2021Article
- Prediction of the effect of dapagliflozin on kidney and heart failure outcomes based on short-term changes in multiple risk markers.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2020Article
- Multimarker Panels in Diabetic Kidney Disease: The Way to Improved Clinical Trial Design and Clinical Practice?Kidney international reports · 2019Review
- An integrative systems biology approach for precision medicine in diabetic kidney disease.Diabetes, obesity & metabolism · 2018Review
- Rationale and protocol of the Study Of diabetic Nephropathy with AtRasentan (SONAR) trial: A clinical trial design novel to diabetic nephropathy.Diabetes, obesity & metabolism · 2018Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsAngiotensin receptor blockers (ARBs) are renoprotective and targeted to blood pressure. However, ARBs have multiple other (off-target) effects which may affect renal outcome. It is unknown whether on-target and off-target effects are congruent within individuals. If not, this variation in short term effects may have important implications for the prediction of individual long term renal outcomes. Our aim was to assess intra-individual variability in multiple parameters in response to ARBs in type 2 diabetes.
methodsChanges in systolic blood pressure (SBP), albuminuria, potassium, haemoglobin, cholesterol and uric acid after 6 months of losartan treatment were assessed in the RENAAL database. Improvement in predictive performance of renal outcomes (ESRD or doubling serum creatinine) for each individual using ARB-induced changes in all risk markers was assessed by the relative integrative discrimination index (RIDI).
resultsSBP response showed high variability (mean -5.7 mmHg, 5(th) to 95(th) percentile -36.5 to +24.0 mmHg) between individuals. Changes in off-target parameters also showed high variability between individuals. No congruency was observed between responses to losartan in multiple parameters within individuals. Using individual responses in all risk markers significantly improved renal risk prediction (RIDI 30.4%, P < 0.01) compared with using only SBP changes. Results were successfully replicated in two independent trials with irbesartan, IDNT and IRMA-2.
conclusionsIn this post hoc analysis we showed that ARBs have multiple off-target effects which vary between and within individuals. Combining all ARB-induced responses beyond SBP provides a more accurate prediction of who will benefit from ARB therapy. Prospective trials are required to validate these findings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.