{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T03:50:19Z","timestamp":1782791419408,"version":"3.54.5"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2020,7,2]],"date-time":"2020-07-02T00:00:00Z","timestamp":1593648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"L & T Charitable Foundation Ltd"},{"name":"University of Hong Kong and the Hong Kong Society of Nephrology Research"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The potential long-term safety and efficacy of aliskiren in nondiabetic chronic kidney disease (CKD) are unknown. We sought to investigate the renoprotective effect of aliskiren on nondiabetic CKD patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this open-label, parallel, randomized controlled trial, nondiabetic CKD Stages 3\u20134 patients were randomized to receive aliskiren added to an angiotensin II receptor blocker (ARB) at the maximal tolerated dose, or ARB alone. Primary outcome was the rate of change in estimated glomerular filtration rate (eGFR). Secondary endpoints included rate of change in urine protein-to-creatinine ratio (UPCR), cardiovascular events and hyperkalemia. Composite renal outcomes of doubling of baseline serum creatinine or a 40% reduction in eGFR or incident end-stage renal disease or death were analyzed as post hoc analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Seventy-six patients were randomized: 37 to aliskiren (mean age 55.1\u2009\u00b1\u200911.1\u2009years) and 39 to control (mean age 55.0\u2009\u00b1\u20099.4\u2009years). Their baseline demographics were comparable to eGFR (31.9\u2009\u00b1\u20099.0 versus 27.7\u2009\u00b1\u20099.0\u2009mL\/min\/1.73\u2009m2, P\u2009=\u20090.05) and UPCR (30.7\u2009\u00b1\u200912.6 versus 47.8\u2009\u00b1\u20092.8\u2009mg\/mmol, P\u2009=\u20090.33) for treatment versus control subjects. After 144\u2009weeks of follow-up, there was no difference in the rate of eGFR change between groups. Six patients in the aliskiren group and seven in the control group reached the renal composite endpoint (16.2% versus 17.9%, P\u2009=\u20090.84). The cardiovascular event rate was 10.8% versus 2.6% (P\u2009=\u20090.217). The hyperkalemia rate was 18.9% versus 5.1% with an adjusted hazard ratio of 7.71 (95% confidence interval 1.14 to 52.3, P\u2009=\u20090.04) for the aliskiren arm.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Aliskiren neither conferred additional renoprotective benefit nor increased adverse events, except for more hyperkalemia in nondiabetic CKD patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ndt\/gfaa085","type":"journal-article","created":{"date-parts":[[2020,3,30]],"date-time":"2020-03-30T19:15:08Z","timestamp":1585595708000},"page":"1648-1656","source":"Crossref","is-referenced-by-count":10,"title":["Direct Renin Inhibition in Non-diabetic chronic Kidney disease (DRINK): a prospective randomized trial"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6862-1941","authenticated-orcid":false,"given":"Sydney C W","family":"Tang","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, The University of Hong Kong and Queen Mary Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kam Wa","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, The University of Hong Kong and Queen Mary Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis K M","family":"Ip","sequence":"additional","affiliation":[{"name":"School of Public Health, The University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desmond Y H","family":"Yap","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, The University of Hong Kong and Queen Mary Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maggie K M","family":"Ma","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, The University of Hong Kong and Queen Mary Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maggie M Y","family":"Mok","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, The University of Hong Kong and Queen Mary Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary C W","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, The University of Hong Kong and Queen Mary Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidney","family":"Tam","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, Queen Mary Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kar Neng","family":"Lai","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, The University of Hong Kong and Queen Mary Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,7,2]]},"reference":[{"key":"2021082722460529500_OP-B1","first-page":"Cd007066","article-title":"Blood pressure lowering efficacy of renin inhibitors for primary hypertension","volume":"4","author":"Musini","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"2021082722460529500_OP-B2","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/S0140-6736(07)61124-6","article-title":"Efficacy and safety of combined use of aliskiren and valsartan in patients with hypertension: a randomised, double-blind 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