Evidence map›Paper›PMID 28033332›Full record

Trial reportPloS one2016

Comparative Effects of Direct Renin Inhibitor and Angiotensin Receptor Blocker on Albuminuria in Hypertensive Patients with Type 2 Diabetes. A Randomized Controlled Trial.

Takashi Uzu, Shin-Ichi Araki, Atsunori Kashiwagi, Masakazu Haneda, Daisuke Koya, Hiroki Yokoyama, Yasuo Kida, Motoyoshi Ikebuchi, Takaaki Nakamura, Masataka Nishimura and 14 more

Open access · goldAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
1.8field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022
    Guideline
  3. Trial
  4. Review
  5. Review
  6. Review
  7. Should ACE inhibitors and ARBs be used in combination in children?Pediatric nephrology (Berlin, Germany) · 2019
    Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors at 12 institutions in 1 country.

Takashi UzuDivision of Nephrology & Blood Purification, Nissay Hospital, Osaka, Japan.
Shin-Ichi ArakiDepartment of Medicine, Sihiga Univ. of Medical Science, Otsu, Shiga, Japan.
Atsunori KashiwagiDepartment of Medicine, Kusatsu General Hospital, Kusatsu, Shiga, Japan.
Masakazu HanedaDepartment of Medicine, Asahikawa Medical Univ., Asahikawa, Hokkaido, Japan.
Daisuke KoyaDepartment of Diabetology and Endocrinology, Kanazawa Medical Univ., Kahoku-gun, Ishikawa, Japan.
Hiroki YokoyamaDepartment of Internal Medicine, Jiyugaoka Medical Clinic, Obihiro, Hokkaido, Japan.
Yasuo KidaDepartment of Medicine, Daini-Okamoto Hospital, Uji, Kyoto, Japan.
Motoyoshi IkebuchiDepartment of Internal Medicine, Ikebuchi Clonic, Osaka, Japan.
Takaaki NakamuraDepartment of Endicrinology and Metabolism, Omi Hachiman Community Medical Center, Omi Hachiman, Shiga, Japan.
Masataka NishimuraDepartment of Medicine, Nagahama City Hospital, Nagahama, Shiga, Japan.
Noriko TakaharaDepartment of Medicine, Ako City Hospital, Ako, Hyogo, Japan.
Toshiyuki ObataDepartment of Medicine, Ako City Hospital, Ako, Hyogo, Japan.
Nobuyuki OmichiDepartment of Medicine, Omichi Clinic, Otsu, Shiga, Japan.
Katsuhiko SakamotoDepartment of Medicine, Sakamoto Clinic, Minoh, Osaka, Iapan.
Ryosuke ShinguDepartment of Medicine, Kitahorie Hospital, Osaka, Japan.
Hideki TakiDiabetes Center, National Hospital Organization National Osaka Hospital, Osaka, Japan.
Yoshio NagaiDivision of Metabolism and Endocrinology, St. Marianna Univ School of Medicine, Kawasaki, Kanagawa, Japan.
Hiroaki TokudaDepartment of Medicine, Tokuda Clinic, Kitamatsu-ura-gun, Nagasaki, Japan.
Munehiro KitadaDepartment of Diabetology and Endocrinology, Kanazawa Medical Univ., Kahoku-gun, Ishikawa, Japan.
Miwa MisawaDepartment of Medicine, Nagahama Red Cross Hospital, Nagahama, Shiga, Japan.
Akira NishiyamaDepartment of Pharmacology, Kagawa Univ. Kida-gun, Kagawa, Japan.
Hiroyuki KoboriDepartment of Pharmacology, Kagawa Univ. Kida-gun, Kagawa, Japan.
Hiroshi MaegawaDepartment of Medicine, Sihiga Univ. of Medical Science, Otsu, Shiga, Japan.
Shiga Committee for Preventing Diabetic Nephropathy
Kanazawa Medical University · JPNagahama City Hospital · JPShiga University of Medical Science · JPAsahikawa Medical University · JPHoshigaoka Medical Center · JPInternational University of Health and Welfare · JPJichi Medical University · JPKagawa University · JPNissay Hospital · JPOsaka Hospital · JPSt. Marianna University School of Medicine · JPWakamoto Pharmaceutical (Japan) · JP

Funding

Intrarenal Augmentation of Angiotensinogen by Ang IIR01DK072408 · NIDDK · TULANE UNIVERSITY OF LOUISIANA · PI NAVAR, LUIS GABRIEL · 2006 to 2010
$1.2M
NIDDK NIH HHS R01 DK072408
6 · The paper itself

Abstract

backgroundIn patients with diabetes, albuminuria is a risk marker of end-stage renal disease and cardiovascular events. An increased renin-angiotensin system activity has been reported to play an important role in the pathological processes in these conditions. We compared the effect of aliskiren, a direct renin inhibitor (DRI), with that of angiotensin receptor blockers (ARBs) on albuminuria and urinary excretion of angiotensinogen, a marker of intrarenal renin-angiotensin system activity.

methodsWe randomly assigned 237 type 2 diabetic patients with high-normal albuminuria (10 to <30 mg/g of albumin-to-creatinine ratio) or microalbuminuria (30 to <300 mg/g) to the DRI group or ARB group (any ARB) with a target blood pressure of <130/80 mmHg. The primary endpoint was a reduction in albuminuria.

resultsTwelve patients dropped out during the observation period, and a total of 225 patients were analyzed. During the study period, the systolic and diastolic blood pressures were not different between the groups. The changes in the urinary albumin-to-creatinine ratio from baseline to the end of the treatment period in the DRI and ARB groups were similar (-5.5% and -6.7%, respectively). In contrast, a significant reduction in the urinary excretion of angiotensinogen was observed in the ARB group but not in the DRI group. In the subgroup analysis, a significant reduction in the albuminuria was observed in the ARB group but not in the DRI group among high-normal albuminuria patients.

conclusionDRI and ARB reduced albuminuria in hypertensive patients with type 2 diabetes. In addition, ARB, but not DRI, reduced albuminuria even in patients with normal albuminuria. DRI is not superior to ARB in the reduction of urinary excretion of albumin and angiotensinogen.

Indexed as

Renin InhibitorsAlbuminuriaAmidesAngiotensinogenAngiotensin Receptor AntagonistsAntihypertensive AgentsBlood PressureCreatinineDiabetes Mellitus, Type 2Diabetic NephropathiesFumaratesHumansHypertensionKidney Failure, ChronicProspective StudiesRenin-Angiotensin SystemaliskirenAmidesAngiotensinogenAngiotensin Receptor AntagonistsAntihypertensive AgentsCreatinineFumaratesRenin Inhibitors

Identifiers

PMID28033332
PMCPMC5198982
OpenAlexW2563595666

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 Socratic graph.