1. ¹Steno Diabetes Center, Gentofte, Denmark
2. ²Department of Medicine University Hospital, Maastricht, The Netherlands
3. ³Section of Vascular Pharmacology and Metabolism, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
4. ⁴Department of Clinical Physiology and Nuclear Medicine, Glostrup Hospital, Glostrup, Denmark
5. ⁵Department of Medical Endocrinology, University Hospital of Copenhagen, Copenhagen, Denmark
6. ⁶Faculty of Health Science, Aarhus University, Aarhus, Denmark

Correspondence: F Persson, Steno Diabetes Center, Niels Steensenvej 2, Gentofte DK-2820, Denmark. E-mail: frip@steno.dk

Received 31 August 2007; Revised 18 December 2007; Accepted 28 December 2007; Published online 12 March 2008.

Abstract

Inhibition of renin with an active site inhibitor, aliskiren, lowers blood pressure (BP) in diabetic patients. Here, we studied the time course of the antihypertensive and antiproteinuric effect of renin inhibition in 15 patients with type 2 diabetes and elevated urinary albumin/creatinine ratios (UACRs) to check whether aliskiren can decrease proteinuria. After a 4-week washout of previous medications, patients received aliskiren and furosemide daily for 28 days followed by a 4-week withdrawal period. Twenty-four-hour BPs were measured at baseline throughout treatment and withdrawal periods. The UACR was significantly reduced after 2–4 days of treatment with another significant reduction after 28 days. Systolic blood pressure (SBP) was significantly lower after 7 days with no further reduction after 28 days. The BP returned toward baseline 3 days after withdrawal, whereas the UACR was still significantly reduced compared with baseline 12 days after withdrawal. Our study shows that aliskiren reduced 24 h SBP, and this was associated with a reduction in albuminuria in type 2 diabetic patients.