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OS 31-06 COMPARISON BETWEEN THE EFFECTS OF HYDROCHLOROTHIAZIDE AND INDAPAMIDE ON THE KIDNEY IN HYPERTENSIVE PATIENTS INADEQUATELY CONTROLLED WITH LOSARTAN.

OBJECTIVE: The aim of the study is to compare the effects of hydrochlorothiazide and indapamide on the kidney in hypertensive patients inadequately controlled with losartan.

DESIGN AND METHOD: 140 hypertensive patients who met the criteria and were inadequately controlled with losartan 50 mg/d for 2 weeks were randomized to administered with hydrochlorothiazide 12.5 mg/d (n = 70) or indapamide (sustained release) 1.5 mg/d (n = 70) in combination with losartan 50 mg/d. Except for the baseline characteristics, the office blood pressure (BP) were collected at baseline and each follow up visit. Creatinine, urine albumin creatinine ratio (ACR), urine neutrophil gelatinase-associated lipocalin (NGAL) and renal resistive index (RRI) were also collected at baseline and the 24 weeks of follow up.

RESULTS: None of the baseline characteristics was statistically significantly different between the two groups. After excluding those patients with office BP uncontrolled in the 4/12 weeks, 46 patients in the hydrochlorothiazide group (45.7% males, 58.8 ± 10.8 years) and 44 patients in the indapamide group (38.4% males, 61.5 ± 10.9 years) were analyzed. There were insignificant change in creatinine and significant decrease in ACR, NGAL, and RRI compared to which at baseline in the two groups. The decrease in ACR (3.8 (0, 28.7) vs 4.2 (0.4, 64.8) mg/g) were not significant different between the two groups, while the decrease in NGAL (14.92 (-1.68, 48.40) vs 28.40 (4.93, 48.32) ng/ml) and RRI (0.04 (-0.005, 0.06) vs 0.08 (-0.100, 0.1250)) were more significant in indapamide group than in hydrochlorothiazide group.

CONCLUSIONS: Indapamide is superior to hydrochlorothiazide to improve renal tubular injury and renal hemodynamics in combination with losartan in hypertensive patients with BP controlled.

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