Long-term anti-proteinuric effect of Losartan in renal transplant recipients treated for hypertension

Background. Hypertension is common after renal transplantation. Angiotensin II type 1 receptor antagonists are a new class of agents that, without the side-effects mediated by kinins, have shown their efficacy in the treatment of hypertension and heart failure. The aim of the study was to assess the efficacy and safety of Losartan for the treatment of hypertension and to evaluate its long-term effect on graft function in a group of stable renal transplant patients. Methods. Eighteen non-diabetic renal transplant recipients evaluated at our unit for more than 1 year after transplantation (13–155 months) were enrolled. Losartan was administered for a period of 14.2±6.86 (6–28) months at a dose of 25–100 mg/day depending on the antihypertensive response obtained. Results. Losartan satisfactorily lowered systemic blood pressure. Overall graft function remained stable and a significant reduction in proteinuria was observed throughout the period on Losartan (1.0±0.87 vs 0.4±0.83 g/l, P=0.003). No serious side-effects were reported except for a significant reduction in the mean haemoglobin concentration (from 13.5±1.74 g/dl to 12.2±2.19 g/dl; P=0.001). Conclusions. A satisfactory antihypertensive effect was observed with long-term therapy with Losartan. A significant reduction in proteinuria without adversely affecting graft function was the main beneficial effect observed. Losartan was generally well tolerated and a decrease in haemoglobin was the major side-effect.