Effects of Candesartan Cilexetil on Urinary Protein Excretion in Patients with Essential Hypertension.

It has been reported that hypertensive renal damage occurs not only in the glomerulus but also in the renal tubule.However,the excretion of urinary proteins other than albumin has not been sufficiently evaluated in hypertensive patients.Theaim of this study was to study the effect of antihypertensive therapy with candesartan cilexetil on urinary protein excretion.Twenty-nine hypertensive patients were enrolled in it.The target of the antihypertensive therapy was less than 140/90mmHg or a reduction of more than 20/10 mmHg.In 20 patients,the therapy decreased blood pressure significantly (from161.1±14.3/95.3±11.6 mmHg to 132.7±7.6/82.8±7.0 mmHg) (p<0.001/p<0.001).Total urinary protein excretion wasalso significantly decreased (from 97.7±49.1 to 66.8±30.9 mg/gCr) (p=0.009).When urinary proteins were electrophoresed using SDS-PAGE,the content of 6 fractions (100 kD,82 kD,64 kD,23 kD,22 kD and 11 kD) was significantly decreased after treatment (p=0.024,0.044,0.009,0.048,0.044,and 0.017,respectively).In 9 patients in whom blood pressure was not lowered sufficiently,total urinary protein excretion and all of theabove urinary protein fractions were decreased,though not significantly.These results suggest that if antihypertensive therapy with candesartan cilexetil lowers blood pressure sufficiently,the excretionof total urinary protein and some glomerular and tubular urinary proteins would also be adequately decreased.Also,the influence of the treatment in this study on urinary protein excretion might differ depending on the urinary protein factions.