• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan+
  • Wellness
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Career
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan+
  • Wellness
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Career
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home The Classics General Medicine Classics

The RENAAL Trial: Losartan in diabetic nephropathy [Classics Series]

byEvan ChenandAndrew Cheung, MD MBA
May 17, 2014
in General Medicine Classics, The Classics
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

Image: PD

1. In patients with type II diabetes and nephropathy, losartan at a dose of 50-100 mg daily significantly reduced the risk of developing end-stage renal disease compared to placebo.

2. While losartan also significantly reduced the degree of proteinuria in these patients, it did not significantly reduce mortality when compared with placebo.

Original Date of Publication: September 20, 2001

Study Rundown: Diabetic nephropathy is a leading cause of end-stage renal disease (ESRD). Previous studies had shown that blockade of the renin-angiotensin system slowed the progression of renal disease in patients with type I diabetes. The RENAAL (Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan) study was the one of the first to assess the effect of disrupting the renin-angiotensin system in patients with type II diabetes. The study demonstrated that in type II diabetic patients already receiving conventional anti-hypertensive therapy, the use of the angiotensin-II-receptor antagonist losartan significantly decreased the risk of ESRD (19.6% vs. 25.5%, 28% risk reduction, p=0.002). Losartan also significantly decreased the degree of proteinuria (p<0.001). There was no significant difference between the groups in mortality rates. One limitation of this study was the high rate at which patients discontinued the study drug. About 53.5% of patients in the placebo group and 46.5% of patients in the losartan group stopped taking their study medication early.

In summary, the findings of this study support the use of losartan in delaying the progression of renal disease in patients with type 2 diabetes and nephropathy.

RELATED REPORTS

Spot capillary HbA1c testing may have a role in early detection of type 2 diabetes

#VisualAbstract: Automated Insulin Delivery Effectively Reduces Blood Glucose Levels in Type 2 Diabetes

Short sleep duration associated with increased risk of diabetes

Click to read the study in NEJM

In-Depth [randomized controlled trial]: Originally published in 2001 in NEJM, this randomized, controlled trial enrolled 1,513 patients from 250 centers in 28 countries. Eligible patients were between 31-70 years of age with diagnoses of type 2 diabetes and nephropathy (i.e., urinary protein ≥0.5 g/24 hours and serum creatinine between 115-254 μmol/L). Patients who had type 1 diabetes, non-diabetic renal disease, or a history of heart failure were excluded. Moreover, patients who had recent myocardial infarction (MI), percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), or cerebrovascular event were excluded. Patients received conventional anti-hypertensive therapy as needed, in addition to either losartan or placebo. Permitted anti-hypertensive therapy included calcium-channel blockers, diuretics, alpha-blockers, and beta-blockers, but not angiotensin-converting-enzyme inhibitors (ACE-Is) or angiotensin-II-receptor antagonists other than losartan. Treatment was administered for a mean of 3.4 years. The primary outcome measure was time to the composite endpoint comprised of ESRD (i.e., need for dialysis or renal transplantation), doubling of serum creatinine level, and death. The secondary endpoints were morbidity and mortality from cardiovascular causes, progression of renal disease, and changes in the degree of proteinuria.

The daily dose of losartan ranged from 50-100 mg daily with 71% of patients receiving 100 mg. Losartan treatment significantly reduced the incidence of the primary endpoint when compared to placebo (43.5% vs. 47.1%, 16% risk reduction, p=0.02). This difference was driven by significant reductions in the risk of doubling serum creatinine (21.6% vs. 26.0%, 25% risk reduction, p=0.006) and the risk of end-stage renal disease (19.6% vs. 25.5%, 28% risk reduction, p=0.002) in the losartan group. There was no significant difference between the two groups in mortality (21.0% vs. 20.3%, p=0.88). Moreover, there was no difference between the groups in the secondary endpoint of morbidity and mortality from cardiovascular causes. Patients in the losartan group, however, did experience significant reductions in the amount of proteinuria when compared with those receiving placebo (p<0.001).

© 2012-2014 2minutemedicine.com. All rights reserved. No works may be reproduced without expressed written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. 

Tags: diabetesDiabetic Nephropathylosartan
Previous Post

Post-operative hospital transfers more likely at Critical Access Hospitals

Next Post

Decreased HIV co-receptor CCR5 expression after IUD insertion

RelatedReports

Food environment associated with gestational diabetes
Chronic Disease

Spot capillary HbA1c testing may have a role in early detection of type 2 diabetes

April 10, 2025
#VisualAbstract: Automated Insulin Delivery Effectively Reduces Blood Glucose Levels in Type 2 Diabetes
StudyGraphics

#VisualAbstract: Automated Insulin Delivery Effectively Reduces Blood Glucose Levels in Type 2 Diabetes

March 31, 2025
Career Development

Short sleep duration associated with increased risk of diabetes

March 14, 2025
Glucagon-like Peptide-1 Receptor Agonists and Lower Depression Risk in Older Adults with Diabetes
StudyGraphics

Glucagon-like Peptide-1 Receptor Agonists and Lower Depression Risk in Older Adults with Diabetes

March 13, 2025
Next Post
New pathogenic dimorphic fungal species suggested in HIV-positive patients

Decreased HIV co-receptor CCR5 expression after IUD insertion

Clinic intervention reduces pregnancy risk behaviors in vulnerable youth

Post-partum Implanon offers long-term contraception for high risk women

Maternal vitamin D status does not affect offspring’s bone-mineral content

The VIDA trial: Vitamin D3 does not improve outcomes in asthma patients

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • App-based physical activity intervention may have a limited role among women with prior hypertensive pregnancy disorder
  • Imlunestrant extends progression-free survival in ER-positive, HER2-negative breast cancer
  • Genomic sequencing identifies variants linked to congenital diarrhea and enteropathies
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Career
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.