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Effect of Losartan on Microalbuminuria in Normotensive Patients with Type 2 Diabetes Mellitus: A Randomized Clinical Trial

Adrienne A.M. Zandbergen, MD; Marinus G.A. Baggen, MD, PhD; Steven W.J. Lamberts, MD, PhD; Aart H. Bootsma, MD, PhD; Dick de Zeeuw, MD, PhD; and Rob J.Th. Ouwendijk, MD, PhD
[+] Article and Author Information

From Ikazia Hospital and Erasmus University Medical Centre, Rotterdam, and University Hospital, Groningen, the Netherlands.


Acknowledgments: The authors thank Wouter Wijker and Ruurd Bennink for their help in statistical analyses, Rob Oosterom for advice on laboratory measurements, and Ron Leeneman of the virtual central laboratory.

Grant Support: By a grant from Merck, Sharp & Dohme, Haarlem, the Netherlands.

Potential Financial Conflicts of Interest:Consultancies: D. de Zeeuw (Bristol-Myers Squibb; Pfizer; Merck, Sharpe & Dohme; Yamanouchi Pharmaceutical Co.; Amgen).

Requests for Single Reprints: Adrienne A.M. Zandbergen, MD, Department of Internal Medicine, Ikazia Hospital, Montessoriweg 1, 3083 AN Rotterdam, the Netherlands; e-mail, adrienne_zandbergen@yahoo.com.

Current Author Addresses: Drs. Zandbergen, Baggen, and Ouwendijk: Department of Internal Medicine, Ikazia Hospital, Montessoriweg 1, 3083 AN Rotterdam, the Netherlands.

Drs. Lamberts and Bootsma: Department of Internal Medicine, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.

Dr. de Zeeuw: Department of Clinical Pharmacology, University Hospital Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, the Netherlands.

Author Contributions: Conception and design: A.A.M. Zandbergen, M.G.A. Baggen, R.J.T. Ouwendijk.

Analysis and interpretation of the data: A.A.M. Zandbergen, M.G.A. Baggen, S.W.J. Lamberts, A.H. Bootsma, D. de Zeeuw, R.J.T. Ouwendijk.

Drafting of the article: A.A.M. Zandbergen.

Critical revision of the article for important intellectual content: M.G.A. Baggen, S.W.J. Lamberts, A.H. Bootsma, D. de Zeeuw, R.J.T. Ouwendijk.

Final approval of the article: A.A.M. Zandbergen, M.G.A. Baggen, S.W.J. Lamberts, A.H. Bootsma, D. de Zeeuw, R.J.T. Ouwendijk.

Provision of study materials or patients: A.A.M. Zandbergen, M.G.A. Baggen, A.H. Bootsma, R.J.T. Ouwendijk.

Statistical expertise: S.W.J. Lamberts, D. de Zeeuw.

Obtaining of funding: M.G.A. Baggen, R.J.T. Ouwendijk.

Administrative, technical, or logistic support: A.A.M. Zandbergen.

Collection and assembly of data: A.A.M. Zandbergen, M.G.A. Baggen, R.J.T. Ouwendijk.


Ann Intern Med. 2003;139(2):90-96. doi:10.7326/0003-4819-139-2-200307150-00008
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To our knowledge, this study is the first randomized, placebo-controlled trial showing that the angiotensin-receptor antagonist losartan reduces urinary albumin excretion in normotensive patients with type 2 diabetes mellitus and microalbuminuria. Because 100 mg of losartan reduced the albumin excretion rate significantly more than did the 50-mg dose, our data also show the incremental benefit of a higher dose. The antiproteinuric effect was reversible upon discontinuation of losartan therapy. Losartan was well tolerated at both doses.

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Figure.
Time course of the effect of losartan and placebo on mean urinary albumin excretion rate.
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Summary for Patients

The Blood Pressure Drug Losartan Appears To Benefit the Kidneys of People with Type 2 Diabetes Who Do Not Have High Blood Pressure

The summary below is from the full report titled “Effect of Losartan on Microalbuminuria in Normotensive Patients with Type 2 Diabetes Mellitus. A Randomized Clinical Trial.” It is in the 15 July 2003 issue of Annals of Internal Medicine (volume 139, pages 90-96). The authors are A.A.M. Zandbergen, M.G.A. Baggen, S.W.J. Lamberts, A.H. Bootsma, D. de Zeeuw, and R.J.Th. Ouwendijk.

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