Sodium Restriction Beats ARBs in Patients with Kidney Disease Who Take ACE Inhibitors

Proteinuria and blood pressure were both better with sodium restriction plus angiotensin-converting-enzyme inhibitors than with angiotensin-receptor blockers plus ACE inhibitors.

Treatment with angiotensin-converting–enzyme (ACE) inhibitors yields favorable kidney and cardiovascular outcomes in patients who have chronic kidney disease. The benefits of adding a sodium-restricted diet, an angiotensin-receptor blocker (ARB), or both are unknown. In this randomized crossover trial, Dutch investigators compared the effects of dietary sodium restriction, ARB therapy (with valsartan [Diovan]), or their combination in lowering proteinuria and systolic blood pressure (SBP) in 52 patients with nondiabetic nephropathy who were receiving an ACE-inhibitor (lisinopril, 40 mg daily).

During each of four 6-week periods, patients received one of four add-on treatment combinations: daily placebo or valsartan (320 mg) plus either a reg…

Reviewing Author

Paul S. Mueller, MD, MPH, FACP

Disclosures

Nothing to disclose

Paul S. Mueller, MD, MPH, FACP

Disclosures

Nothing to disclose