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High-Dose Candesartan Can Reduce Proteinuria

Daily 128-mg dose lowered protein excretion more than traditional 16-mg dose

THURSDAY, Feb. 19 (HealthDay News) -- Extra-high dosages of candesartan may be beneficial in reducing persistent proteinuria, according to research published online Feb. 11 in the Journal of the American Society of Nephrology.

Ellen Burgess, M.D., of the University of Calgary in Alberta, Canada, and colleagues analyzed data from 269 patients with primary glomerular disease, diabetes or hypertensive glomerulosclerosis who maintained persistent proteinuria despite taking 16 mg of candesartan daily. Patients were randomized to receive 16, 64 or 128 milligrams of candesartan daily for 30 weeks.

Compared to the 16-mg group, those in the 128-mg group showed a 33.05 percent drop in 24-hour urine protein excretion, the researchers report. Twenty-four patients discontinued the study due to adverse events, most commonly elevated serum potassium, the authors note. However, participants did not show dosage-related increases in adverse events.

"This study demonstrated that using the angiotensin type 1 receptor blocker candesartan at the dosage of 128 mg/d, a dosage much higher than the maximum dosage recommended for the treatment of hypertension or heart failure, results in a further significant reduction in urinary protein excretion," the authors write. "With biochemical monitoring and appropriate dietary counseling as needed, this study has demonstrated that a broad range of patients with proteinuria can benefit from high-dosage candesartan treatment in a safe manner."

AstraZeneca Canada supported and participated in the study.

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