The angiotensin receptor blocker losartan inhibited urate transporter 1 urat1 according to in vitro experiments. Feb 01, 2001 read uricosuric effect of losartan in renal transplanted patients, transplantation proceedings on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Effect of losartan versus candesartan on uric acid, renal. Pdf the hypotensive and uricosuric effect of valsartan compared. Antihypertensive drugs can increase or decrease the development of incident gout in patients with hypertension, with losartan and calcium channel blockers having the greatest lowering effect on blood pressure because of their uricosuric properties. This observation suggests that the modest uricosuric effect of. Aug 18, 2019 losartan appears to be a safe and efficacious agent to lower serum uric acid levels in patients with hyperuricemia.
Renal hemodynamic effects of ang ii receptor antagonists. However, there have also been some studies which have shown significant favorable changes in the various parameters 9. Main outcome measure relative risk of incident gout. Removal of the negative feedback of angiotensin ii causes a 2 to 3fold rise in plasma renin activity and. The 2012 acr guidelines endorse the use of additional uricosuric agents such as fenofibrate and losartan in combination with xanthine oxidase inhibitors if target. The increase was found to be dose dependent and to persist after seven days of administration. Antihypertensive drugs and risk of incident gout among.
Uricosuric action of losartan via the inhibition of urate transporter 1. Effect of a reduction in uric acid on renal outcomes. Abdominal surgery also has a uricosuric effect, as well as the potential to precipitate an acute attack of gout. Whether this uricosuric effect of losartan, but not exp 3174, represents an advantage or an inconvenience is still not clear. The effect of angiotensin ii receptor blockers on hyperuricemia ncbi. Four individuals experienced an acute gouty attack after being switched from losartan back to enalapril therapy. Effect of losartan on different biochemical parameters in. Various studies carried out with losartan showed no significant changes in the biochemical parameters. In general, uricosuric drugs act on the proximal tubules in the kidneyswhere they interfere with the absorption of uric acid from the kidney back into the blood. Read uricosuric effect of losartan in renal transplanted patients, transplantation proceedings on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. This study evaluates the uricosuric effects of losartan in 10 hypertensive heart transplant patients with hyperuricemia. In summary, hypertension and hyperuricaemia commonly coexist. Effects of losartan on renal function in patients with. Effect of losartan versus candesartan on uric urcosuric, renal function, and fibrinogen in patients with hypertension and hyperuricemia associated with diuretics.
Pilot study of the uricosuric effect of dup753, a new. In the losartan monotherapy group, uric acid levels decreased from 8. Concentrationdependent mode of interaction of angiotensin. Comparison between the effects of the losartan and enalapril. In some persons with lossoffunction mutations of urat1, the uricosurics benzbromarone and losartan had no effect, suggesting these drugs act on urat1 in vivo. The present study was designed to evaluate the effect of losartan monodrug therapy on different biochemical parameters. In this study, we found that in hypertensive patients the effects of losartan on renal excretion of urate differed significantly from those of candesartan. In a singledose study in normal volunteers, losartan had no effects on glomerular filtration rate, renal plasma flow or filtration fraction.
Effects of losartan on renal function in patients with essen. The effect of angiotensin ii receptor blockers on hyperuricemia marissa l. Subsequently, the uricosuric effect of losartan was demonstrated in normotensive subjects studied on a high and a lowsodium diet 151. Because an uricosuric effect is of clinical interest, especially in adjuvant therapy with diuretics agents, further studies should be undertaken to clarify this mechanism. Renal effects of angiotensin ii receptor blockade in normotensive. Hypertension are present almost 30% inhyperuricemia and gouty. The uricosuric effect of losartan was not found to be dosedependent 100 mgday did not appear to be more effective than 50 mgday. Second, we examined the effect of losartan and benzbromarone on urinary urate excretion in hypertensive patients with idiopathic hypouricemia with homozygote and compound heterozygote of lossoffunction mutations of urat1. Losartan inhibits the pressor effect of angiotensin ii as well as angiotensin i infusions. Although being developed principally as an antihypertensive agent, losartan has an important role in defining the physiological and pathophysiological roles of aii in virtually every tissue and organ system in the body. Effects of losartan on a background of hydrochlorothiazide in. Dec 31, 2019 in the losartan monotherapy group, uric acid levels decreased from 8. Swelling of your face, throat, eyes, legs, or other body parts. Uricosuric effect of losartan in renal transplanted patients.
There was a small uricosuric effect leading to a minimal decrease in. Renal effects of angiotensin ii receptor blockade in. This study have done at the outpatient clinic and ward in mohammad hoesin hospital rsmh palembang. Tell your doctor if any side effect gets worse or does not go away. The hypotensive and uricosuric effect of valsartan compared to losartan in gout patients article pdf available january 2016 with 1 reads how we measure reads. Losartan, but not its metabolite, has modest doserelated uricosuric properties. Elizabeth ripley, ari hirschdivision of nephrology, virginia commonwealth university, richmond, virginia, usaabstract. During those years, researchers and clinicians have developed a growing base of. Elevated serum uric acid is highly predictive of mortality in patients with heart failure or coronary artery disease and of cardiovascular events. Effects of losartan and candesartan on bp and renal. Wilcoxons test was used to assess the effect of losartan on hypouricemic patients. Effect of a reduction in uric acid on renal outcomes during. A dose of 100 mg inhibits the pressor effect by about 85% at peak with 2540% inhibition persisting for 24 hours.
Hamada t1, ichida k, hosoyamada m, mizuta e, yanagihara k, sonoyama k, sugihara s, igawa o, hosoya t, ohtahara a, shigamasa c, yamamoto y, ninomiya h, hisatome i. Nov 10, 2005 losartan, an angiotensin ii receptor antagonist, is an effective antihypertensive drug that also has a uricosuric effect due to its molecular disposition or physical property. Jan 12, 2012 objective to determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension. Jan 12, 2012 in summary, hypertension and hyperuricaemia commonly coexist. Losartan is the only arb that has this uricosuric effect, and in fact it is the only exception within a drug class effect. Effects of losartan and irbesartan on serum uric acid in hypertensive. If hypertensive patients with left ventricular hypertrophy or type 2 diabetic nephropathy patients require titration from initial dose, increase to 100 mg orally once a day. We report renal effects of losartan, a new orally active aii at1 receptor antagonist used to treat hypertension. Angiotensin is known to lower uric acid renal clearance, but the uricosuric effect of losartan did not appear to be mediated by angiotensin inhibition. Mean systolic and diastolic bp were reduced in the candesartan group, from 156 mm hg at baseline to 2 mm hg at 24 weeks, and from 90. Summarya substantial body of epidemiological and experimental evidence suggests that serum uric acid is an important, independent risk factor for cardiovascular and renal disease especially in patients with hypertension, heart failure, or diabetes. Effects of losartan on a background of hydrochlorothiazide in patients with hypertension.
Comparative effects of losartan and irbesartan on serum uric. In patients pretreated with thiazide diuretics, losartan has been shown to blunt. It was reported that the uricosuric effect of losartan results from its inhibitory action on the urateanion exchanger at the brushborder membranes of the renal proximal tubular epithelial cells rochramel et al. Our data have confirmed the mild uricosuric and hypouricaemic effect of losartan, whereas for the first time, it is shown that combination therapy with indapamide and losartan is not associated with any change in serum uric acid levels. Participants all incident cases of gout n24 768 among adults aged 2079 and a random sample of 50 000 matched controls. This agent promotes uric acid excretion via effects on the organic anion transport the aiia losartan also produces a uricosuric effect in healthy volunteers. The average of uric acid urine level 24 hours before losartan treatment was 369,03 146,49 mg24 hourswas significantly difference 141,63 mg24 hours 95% ci. Losartan, an angiotensin ii receptor antagonist, is an effective antihypertensive drug that also has a uricosuric effect due to its molecular. Effects of losartan on a background of hydrochlorothiazide.
Uricosuric effect of losartan in patients with renal transplants. To explore the effect of urate transporter 1 urat1 polymorphisms on the hypertensive patients with hyperuricemia and the uricosuric action of losartan therapy among hypertensive patients with. Early studies in the healthy population demonstrated that the peak uricosuric effect was already observed 2 to 4 hours after administration. Neither losartan or its metabolite inhibit the angiotensin converting enzyme, other hormone receptors, or ion channels. Uricosuric definition of uricosuric by medical dictionary. Losartan effect decreased uric acid serum and urine levelin. Losartan potassium is a white to offwhite freeflowing crystalline powder with a molecular weight of 461.
There was a small uricosuric effect leading to a minimal. The angiotensin ii receptor antagonist losartan is an effective antihypertensive agent with unique uricosuric properties. Effect of the angiotensin ii receptor antagonist losartan. Cozaar losartan potassium dose, indications, adverse. The uricosuric effect of losartan appears to decrease with time when a new steady state of lower serum uric acid is reached. Objective to determine the independent associations of antihypertensive drugs with the risk of incident gout among people with hypertension. The uricosuric response to losartan was comparable with both types of sodium diet, suggesting that the uricosuric effect of this compound is independent of the blockade of the reninangiotensin. Interestingly, this uricosuric effect of losartan is not associated with. In multipledose studies in hypertensive patients, there were no notable effects on. Losartanhydrochlorothiazide is a prescription drug thats used to treat high blood pressure hypertension. Losartan, an angiotensin ii receptor antagonist, is an effective antihypertensive drug that also has a uricosuric effect due to its molecular disposition or physical property. Uricosuric action of losartan via the inhibition of urate transporter 1 urat 1 in hypertensive patients. Losartan is associated with doserelated antiproteinuric effects.
Comparative effects of losartan and irbesartan on serum. Conclusions in contrast to irbesartan, losartan was uricosuric and decreased serum uric acid levels. Uricosuric medications drugs are substances that increase the excretion of uric acid in the urine, thus reducing the concentration of uric acid in blood plasma. This observation suggests that the modest uricosuric effect of losartan was sustained over 12 weeks, which may represent a potential advantage of the losartan plus hctz combination. Losartan, the first at1 receptor blocker arb, was fda approved 15 years ago. As a specific inhibitor of the urate transporter 1 slc22a12, urat1, losartan blocks the uptake of uric acid into cells, thus leaving more available in the bloodstream to be filtered and excreted by the kidneys. A literature search of medline 1946 to june 2015 and embase 1947 to june 2015 was conducted. Losartan is the first of a new class of potent and specific at 1selective nonpeptide aii receptor antagonists. Uricosuric action of losartan via the inhibition of urate. Angiotensin ii receptor antagonists in hypertension. Aim of this study to evaluate the effect of losartan in lowering the uric acid serum and urine level. A total of 59 patients were entered into the study 30 in the losartan and 29 in the candesartan group.
This study proved the effect of losartan on the decreased uric acid serum and uric acid urine 24 hourslevels. Losartan effect decreased uric acid serum and urine. Removal of the negative feedback of angiotensin ii causes a 2 to 3fold rise in plasma renin activity and consequent rise in. It is freely soluble in water, soluble in alcohols, and slightly soluble in common organic solvents, such as. Fenofibrate and losartan annals of the rheumatic diseases. Effects of losartan and irbesartan on serum uric acid in. The effect of angiotensin ii receptor blockers on hyperuricemia. Treatment with the antihypertensive drug losartan lowers sua. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.
Thus, uricosuric drugs may be candidates for management in a personalized medicine model. Pdf the hypotensive and uricosuric effect of valsartan. Antihypertension is substantially present within 1 week but in some studies the maximal effect occurred in. In the hydrochlorothiazide monotherapy group, uric acid levels increased from 8.
Our data indicate that losartan induces asignificant decrease in the urinary excretion of hypoxanthine. Our objective was to investigate the possible relationship between previous or concurrent use of losartan or valsartan and gout. In this study, we first confirmed the uricosuric action of losartan in hypertensive patients in comparison with candesartan. Losartan appears to be a safe and efficacious agent to lower serum uric acid levels in patients with hyperuricemia. Urat1 is the central mediator in the transport of uric acid from the kidney into the blood. Concentrationdependent mode of interaction of angiotensin ii. Comparison between the effects of the losartan and. Data sources include ibm watson micromedex updated 10 apr 2020, cerner multum updated 6 apr 2020. The effects of the addition of losartan on uric acid. Losartan demonstrated statistically significant reductions in serum uric acid levels or increases in. Your voice becomes hoarse, or you have difficulty breathing or tightness in your throat. Antihypertensives in people with gout or asymptomatic. Losartan is an angiotensin ii receptor blocker arb that has uricosuric effects via inhibition of the urat1 and glucose transporter glut9.
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