Valsartan cuts microalbuminuria in impaired glucose tolerance

(HealthDay)—For patients with impaired glucose tolerance (IGT), valsartan is associated with reduced incidence of microalbuminuria, according to a study published online Jan. 17 in Diabetes, Obesity and Metabolism.

Gemma Currie, M.B., Ch.B., from the University of Glasgow in the United Kingdom, and colleagues examined the impact of valsartan on kidney outcomes in 9,306 patients with IGT. Participants were randomized to valsartan or placebo and were followed for a median of 6.2 years.

The researchers found that valsartan correlated with a reduction in diabetes incidence, but not in cardiovascular events. End-stage renal disease or doubling of serum creatinine occurred in 0.5 and 0.6 percent of patients in the valsartan versus placebo groups, respectively (hazard ratio, 0.96; 95 percent confidence interval, 0.55 to 1.66; P = 0.87). Few patients developed an estimated glomerular filtration rate of ≤30 mL/min/1.73 m² or had renal hospitalization. Microalbuminuria developed in fewer patients on valsartan than placebo (5.8 versus 8.4 percent; hazard ratio, 0.68; 95 percent confidence interval, 0.57 to 0.80; P < 0.0001); macroalbuminuria developed in fewer valsartan-treated patients. Urinary albumin to creatinine ratio was 11 percent lower with valsartan, and 9 percent lower after adjustment for glucose and blood pressure (both P < 0.0001).

"Valsartan reduced the incidence of microalbuminuria in IGT without increasing the incidence of hyperkalemia or renal dysfunction compared with placebo," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Novartis, which manufactures valsartan and funded the main NAVIGATOR study.