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• W2063417654 abstract "Reduction of residual albuminuria during single–agent renin-angiotensin-aldosterone blockade is accompanied by improved cardiorenal outcomes in CKD. We studied the individual and combined effects of the vitamin D receptor activator paricalcitol (PARI) and dietary sodium restriction on residual albuminuria in CKD. In a multicenter, randomized, placebo (PLAC)–controlled, crossover trial, 45 patients with nondiabetic CKD stages 1–3 and albuminuria >300 mg/24 h despite ramipril at 10 mg/d and BP<140/90 mmHg were treated for four 8-week periods with PARI (2 <i>μ</i>g/d) or PLAC, each combined with a low-sodium (LS) or regular sodium (RS) diet. We analyzed the treatment effect by linear mixed effect models for repeated measurements. In the intention-to-treat analysis, albuminuria (geometric mean) was 1060 (95% confidence interval, 778 to 1443) mg/24 h during RS + PLAC and 990 (95% confidence interval, 755 to 1299) mg/24 h during RS + PARI (<i>P</i>=0.20 versus RS + PLAC). LS + PLAC reduced albuminuria to 717 (95% confidence interval, 512 to 1005) mg/24 h (<i>P</i><0.001 versus RS + PLAC), and LS + PARI reduced albuminuria to 683 (95% confidence interval, 502 to 929) mg/24 h (<i>P</i><0.001 versus RS + PLAC). The reduction by PARI beyond the effect of LS was nonsignificant (<i>P</i>=0.60). In the per-protocol analysis restricted to participants with ≥95% compliance with study medication, PARI did provide further albuminuria reduction (<i>P</i>=0.04 LS + PARI versus LS + PLAC). Dietary adherence was good as reflected by urinary excretion of 174±64 mmol Na⁺ per day in the combined RS groups and 108±61 mmol Na⁺ per day in the LS groups (<i>P</i><0.001). In conclusion, moderate dietary sodium restriction substantially reduced residual albuminuria during fixed dose angiotensin–converting enzyme inhibition. The additional effect of PARI was small and nonsignificant." @default.
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• W2063417654 date "1998-12-19" @default.
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• W2063417654 title "The brain, circadian rhythms, and clock genes" @default.
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• W2063417654 doi "https://doi.org/10.1136/bmj.317.7174.1704" @default.
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