{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T13:03:40Z","timestamp":1754485420154},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Exp Clin Endocrinol Diabetes"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\nDual renin-angiotensin-aldosterone blockade (dRAASb) is purposed in the prevention of the cardiorenal syndrome (CRS). However, all attempts with dRAASb even in patients with moderate impaired chronic kidney disease (CKD) were terminated due to the typical severe adverse events (SAE), e.\u2009g., hyperkalemia and rise of serum creatinine. The aim of our study with the direct renin inhibitor aliskiren was to evaluate the effect of dRAASb with a washout phase in patients with severely advanced CKD.<\/jats:p><jats:p>\nWe have studied 45 patients (G3b to 4, A2 and &gt;A3; median glomerular filtration rate (GFR) CKD-EPI 31 (23\u201340) ml\/min per 1.73\u2009m\u00b2 BSA (body surface area), albumin-creatinine-ratio in urine (UACR) (0.413 (0.164 to 1.39) g\/g) and proteinuria (0.5 (0.2 to 0.9) g\/l) before, with and without aliskiren (150 respectively 300\u2009mg per day) added to an angiotensin-converting enzyme inhibitor (ACEi) or an AT1-receptor blocker (ARB) over 4 \u00bd years.<\/jats:p><jats:p>\nThe dRAASb with aliskiren showed a significant decrease of proteinuria (0.5 to 0.38\u2009g\/l), especially in patients with an UACR\u2265350\u2009mg\/g and in the subgroup analysis e.\u2009g., in patients with diabetes, but proteinuria increased in the washout phase again. The blood pressure (130\/80\u2009mm Hg), serum potassium (4.9 to 5.0\u2009mmol\/l) and GFR remained nearly constant (31 to 29.5\u2009ml\/min per 1.73\u2009m2 BSA). A more than 30% increase in serum creatinine was associated with an UACR&gt;300\u2009mg\/g.<\/jats:p><jats:p>\nThe dRAASb has beneficial effects on proteinuria and is safe in patients with severely advanced CKD. However, in patients with high UACR (&gt;300\u2009mg\/g) raise of creatinine and potassium have to be controlled.<\/jats:p>","DOI":"10.1055\/s-0043-106440","type":"journal-article","created":{"date-parts":[[2017,4,27]],"date-time":"2017-04-27T22:48:51Z","timestamp":1493333331000},"page":"39-52","source":"Crossref","is-referenced-by-count":2,"title":["Dual RAAS Blockade with Aliskiren in Patients with Severely Impaired Chronic Kidney Disease"],"prefix":"10.1055","volume":"126","author":[{"given":"Franz","family":"Rasche","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Neurology, Dermatology, Clinic for Endocrinology, Diabetology and Nephrology, University Leipzig, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Joel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Neurology, Dermatology, Clinic for Endocrinology, Diabetology and Nephrology, University Leipzig, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Ebert","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Neurology, Dermatology, Clinic for Endocrinology, Diabetology and Nephrology, University Leipzig, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Frese","sequence":"additional","affiliation":[{"name":"Institute of General Practice and Family Medicine, Martin-Luther-University Halle\/Wittenberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filip","family":"Barinka","sequence":"additional","affiliation":[{"name":"Center for Geriatric Medicine at Bezirksklinikum Regensburg, Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Volker","family":"Busch","sequence":"additional","affiliation":[{"name":"Center for Geriatric Medicine at Bezirksklinikum Regensburg, Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilma","family":"Rasche","sequence":"additional","affiliation":[{"name":"Department of Head Medicine and Oral Health, Department of Ophthalmology, University Leipzig, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Lindner","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Neurology, Dermatology, Clinic for Endocrinology, Diabetology and Nephrology, University Leipzig, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jochen","family":"Schneider","sequence":"additional","affiliation":[{"name":"Translational & Experimental Medicine, Luxembourg Centre de Systems Biomedicine, Luxembourg"},{"name":"Department of Internal Medicine II, Saarland University, Homburg Saar, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Schiekofer","sequence":"additional","affiliation":[{"name":"Center for Geriatric Medicine at Bezirksklinikum Regensburg, Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2017,4,27]]},"container-title":["Experimental and Clinical Endocrinology &amp; Diabetes"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-106440.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,1,24]],"date-time":"2018-01-24T23:32:23Z","timestamp":1516836743000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-106440"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4,27]]},"references-count":0,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2018,1,24]]},"published-print":{"date-parts":[[2018,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-106440","relation":{},"ISSN":["0947-7349","1439-3646"],"issn-type":[{"value":"0947-7349","type":"print"},{"value":"1439-3646","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4,27]]}}}