Vicente E Torres, Kaleab Z Abebe, Arlene B Chapman, Robert W Schrier, William E Braun, Theodore I Steinman, Franz T Winklhofer, Godela Brosnahan, Peter G Czarnecki, Marie C Hogan, Dana C Miskulin, Frederic F Rahbari-Oskoui, Jared J Grantham, Peter C Harris, Michael F Flessner, Charity G Moore, Ronald D Perrone
BACKGROUND: Hypertension develops early in patients with autosomal dominant polycystic kidney disease (ADPKD) and is associated with disease progression. The renin-angiotensin-aldosterone system (RAAS) is implicated in the pathogenesis of hypertension in patients with ADPKD. Dual blockade of the RAAS may circumvent compensatory mechanisms that limit the efficacy of monotherapy with an angiotensin-converting-enzyme (ACE) inhibitor or angiotensin II-receptor blocker (ARB). METHODS: In this double-blind, placebo-controlled trial, we randomly assigned 486 patients, 18 to 64 years of age, with ADPKD (estimated glomerular filtration rate [GFR], 25 to 60 ml per minute per 1...
December 11, 2014: New England Journal of Medicine