P-179: The safety and efficacy of supramaximal doses of candesartan cilexetil (160mg) in chronic renal disease patients naīve to angiotensin receptor blockade therapy

We examined the effect of supramaximal doses of candesartan cilexetil (SDCC), 160mg, in 10 patients with chronic renal disease (CRD; proteinuria > 500mg%, serum creatinine 0.05) at baseline (57±16 ml min−1) and at 160 mg CC (50±25 ml min−1). There was a significant reduction in SBP from 134 to 124 mmHg (p=0.04) while the DBP dropped from 84 to 76mmHg (p=0.02). In summary, SDCC (160mg) was associated with no significant adverse effects. However, SDCC lowered SBP, DBP and urinary 24 hour urinary protein excretion. Future investigations are warranted to evaluate the use of supramaximal doses of ARBs for more complete blockade of the tissue RAS to maximize renal protective effects.