Design and rationale of the study of assessment for kidney function by urinary microalbumin in randomized (SAKURA) trial

Hiroaki Matsuoka, Katsuyuki Ando, Kenji Ueshima, Tetsuya Babazono, Kazuomi Kario, Shiro Tanaka, Kazuwa Nakao, Toshiro Fujita

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Recently, it has been demonstrated that L-/N-type calcium channel blockers (CCBs), cilnidipine, but not L-type CCB, decreased urinary protein in renin-angiotensin system (RAS), inhibitor-treated hypertensive patients with macroproteinuria. However, the antiproteinuric effect of cilnidipine was weaker in diabetic patients than in nondiabetic patients with macroproteinuria. This may be due to the fact that diabetic neuropathy was also developed in patients with advanced diabetic nephropathy because L-/N-type CCB has been considered to exert its renoprotetive effects through sympatholytic action. If so, the antiproteinuric effect of cilnidipine may be potent in patients with early stages of diabetic nephropathy. To elucidate our hypothesis, we designed a multi-center, open-labeled, randomized trial to compare the antialbuminuric effect between cilnidipine and amlodipine in RAS inhibitor-treated hypertensive (blood pressure [BP]: 130180/80110 mmHg) patients with type 2 diabetes and microalbuminuria (urinary albumin/creatinine [Cr] ratio: 30300 mg/g). The primary study endpoint is the change in the urinary albumin/Cr ratio after a 1-year treatment. Enrollment began in April 2008 and was completed in March 2010. A total of 367 patients were randomly allocated to receive cilnidipine or amlodipine. At baseline, study subjects had 63.3± 8.5 years of age, 145.9 ± 12.2/80.8 ± 10.0 mmHg of BP, 101.0 ± 111.6 mg/g of urinary albumin/Cr. The trial is expected to show whether cilnidipine can exert an antialbuminuric effect in RAS inhibitor-treated hypertensive patients with early stages of diabetic nephropathy.

Original languageEnglish
Pages (from-to)455-462
Number of pages8
JournalClinical and Experimental Hypertension
Volume33
Issue number7
DOIs
StatePublished - Nov 2011
Externally publishedYes

Keywords

  • Angiotensin converting enzyme inhibitor
  • Angiotensin receptor blocker
  • Diabetic nephropathy
  • Hypertension
  • L-/N-type calcium channel blocker
  • Urinary albumin

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