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Nature Reviews Nephrology 5, 367–368 (1 July 2009) | doi:10.1038/nrneph.2009.77

Proteinuria: Increased angiotensin-receptor blocking is not the first option

Piero Ruggenenti , Paolo Cravedi & Giuseppe Remuzzi

Burgess and co-workers reported that increasing dosage of the angiotensin-receptor blocker (ARB) candesartan above the maximum recommended antihypertensive dose of 16 mg per day increased the drug's antiproteinuric effects, even though these supramaximal doses did not result in significant changes in blood pressure when compared with the 16 mg per day dosage. Patients with persistent proteinuria |[ge]|1 g per day randomly assigned to 30 weeks of 128 mg per day candesartan doses achieved a 33% greater reduction in proteinuria than patients assigned to 30 weeks of 16 mg per day doses.