WASHINGTON—Adding aliskiren to losartan confers no additional renoprotective benefit among patients with nondiabetic chronic kidney disease (CKD) and increases their risk of hyperkalemia, according to study data presented at the American Society of Nephrology’s Kidney Week 2019 meeting.
Sydney C.W. Tang, MD, of the University of Hong Kong, and colleagues randomly assigned 76 patients with nondiabetic CKD stages 3-4 to received losartan alone (39 patients) or aliskiren plus lostartan (37 patients). In both groups, the mean age was 55 years.
After a mean follow-up of 144 weeks, the investigators found no significant difference between study arms in the slope of estimated glomerular filtration rate (eGFR), the primary study outcome end point. Additionally, similar proportions of the aliskiren-losartan and losartan-only arms reached a renal composite end point of a doubling of baseline serum creatinine, 40% reduction in eGFR, incident end-stage renal disease, or death (16.2% vs 17.9%).
The aliskiren-losartan group had a significantly higher rate of hyperkalemia than the losartan-only arm (18.9% vs 5.1%). The aliskiren-losartan recipients had a higher rate of cardiovascular events (10.8% vs 2.6%), but the between-group difference was not significant.
Tang SCW, Chan Kw, Yap DYH, et al. A phase 3 randomized controlled trial on the effect of losartan vs. add-on aliskiren in CKD. Presented at the American Society of Nephrology’s Kidney Week 2019 meeting held November 5 to 10 in Washington, DC. Poster TH-PO1199.