Azilsartan in Patients With Diabetic Kidney Disease and Hypertension

NCT05753696 — Not applicable, Unknown, 106 participants, Second Affiliated Hospital, Zhejiang University, School of Medicine

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The Effect of Azilsartan in Patients With Diabetic Kidney Disease and Hypertension

RegistryNCT05753696
StatusUnknown
PhaseNot applicable
Study typeInterventional; randomized, parallel, masking: none, treatment
Enrollment106 (Estimated)
SponsorSecond Affiliated Hospital, Zhejiang University, School of Medicine (Other)
ConditionsProteinuria, Kidney Dysfunction, Blood Pressure, Diabetic Kidney Disease
InterventionsAzilsartan, Losartan (Drug)
Datesstart 2023-04-01 (estimated), primary completion 2024-10-30 (estimated), completion 2024-12-30 (estimated), first posted 2023-03-03, last updated 2023-03-03
Locations1 site in China

Related Papers Related Patents Related Grants Related Experts
All trials for Proteinuria All trials for Kidney Dysfunction All trials of Azilsartan All trials of Losartan

-Summary

Hypertension is the most common complication in patients with diabetes nephropathy. Strengthening blood pressure and blood sugar control is the basic treatment for patients with diabetes nephropathy. Angiotensin receptor blocker (ARB) and angiotensin-converting enzyme inhibitor (ACEI) are the first line drugs recommended in domestic and international guidelines for diabetes patients to control hypertension. As a new ARB drug, azilsartan has been found to have better antihypertensive effect than other ARB drugs. However, due to the limited sample size and study time, azilsartan has no significant advantage over other ARB drugs in terms of renal protection effect, and has not been systematically studied in diabetes nephropathy population. This study is intended to evaluate the effect of azilsartan on proteinuria and blood pressure improvement in patients with diabetes nephropathy and hypertension through clinical randomized controlled study, so as to accumulate evidence-based evidence of azilsartan in the comprehensive management of heart and kidney protection in this group of people, and promote the development of comprehensive treatment for patients with metabolic disease and renal injury combined with hypertension. This study will compare the advantages and disadvantages of azilsartan and classical ARB drug losartan potassium in terms of proteinuria, blood pressure control and renal function protection in patients with diabetes nephropathy and hypertension; We propose that the main indicator is the change of urinary albumin/creatinine ratio relative to the baseline, and the secondary indicator is the change of 24-hour urinary protein relative to the baseline; Change of blood pressure relative to baseline; Renal function, electrolyte and blood glucose.

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+Arms and interventions

ArmTypeInterventionsDescription
azilsartan groupExperimentalDrug: Azilsartanthe initial dose of azilsartan is 20mg/day, if not reached the goal of blood pressure, azilsartan was adjust to 40mg/day
losartan groupActive comparatorDrug: Losartanthe initial dose of losartan is 40mg/day, if not reached the goal of blood pressure, losartan was adjust to 80mg/day
  • Azilsartan (Drug): Azilsartan initial dose 20mg/d, if not reached the goal of hypertension; azilsartan dose 40mg/d
  • Losartan (Drug): losartan initial dose 40mg/d, if not reached the goal of hypertension; losartan 100mg/d

+Outcome measures

Primary outcomes

  • proteinuria [up to 16 weeks]: urinary protein

Secondary outcomes

  • 24 hour urine protein [up to 16 weeks]: 24 hour total protein
  • blood pressure [up to 16 weeks]: bp
  • kidney function [up to 16 weeks]: creatine, Blood Urine Nitrogen
  • urinary albumin/ creatine [up to 16 weeks]: urinary albumin/ creatine

+Eligibility

Sex: All, ages: 30 Years to 70 Years

Inclusion Criteria:

* Age 30 to 70;
* Type 2 diabetes diagnosed according to American Diabetes Association guidelines has stable blood sugar control, and glycosylated hemoglobin is less than 7.5%;
* The patient's blood pressure Systemic Blood Pressure (SBP) >140 or Diastolic Blood Pressure (DBP) >90 mmHg, has not taken antihypertensive drugs or is taking non-ARB/ACEI antihypertensive drugs;
* Urine albumin/creatinine ratio>300mg/g.

Exclusion Criteria:

* Type 1 diabetes;
* The patient is considered as non-essential hypertension, such as hypertension caused by renal hypertension or endocrine disease;
* Contraindications of ARB drugs, such as pregnancy status, bilateral renal artery stenosis, allergy to ARB drugs and their excipients;
* It is expected that dialysis treatment will be carried out within 6 months;
* Patients with malignant tumors;
* Patients with mental illness;
* The researcher believes that others are not suitable for this study.

+Locations (1)

FacilityCityCountryStatus
the Second Afficiated Hospital, Zhejiang University, School of MedicineHanzhou, ZhejiangChinaRecruiting

+Publications

  • Results publication: Natale P, Palmer SC, Navaneethan SD, Craig JC, Strippoli GF. Angiotensin-converting-enzyme inhibitors and angiotensin receptor blockers for preventing the progression of diabetic kidney disease. Cochrane Database Syst Rev. 2024 Apr 29;4(4):CD006257. doi: 10.1002/14651858.CD006257.pub2. PMID 38682786

+Investigators

  • Zhida Chen, Principal investigator, The second afiliated hospital of zhejiang university, school of medicine