Optimal antiproteinuric dose of losartan in nondiabetic patients with nephrotic range proteinuria

Am J Kidney Dis. 2001 Dec;38(6):1381-4. doi: 10.1053/ajkd.2001.29262.


Although the antiproteinuric response to antihypertensive treatment is the main predictor of renoprotective efficacy in long-term renal disease, to date, dose-finding studies of antihypertensives have been based only on blood pressure. We aimed to find the optimal antiproteinuric dose of the angiotensin II antagonist losartan. An open-label, dose-response study using subsequent 6-week treatment periods was performed in 10 nondiabetic patients with proteinuria of 5.8 +/- 0.8 g/d and a mean arterial pressure of 103 +/- 3.7 mm Hg without antihypertensive medication. All patients had normal to moderately impaired renal function. After the baseline period, five periods followed with a daily losartan dose of 50 mg, 100 mg, 150 mg, and 50 mg and a recovery without losartan. At the end of each period, proteinuria and mean arterial pressure were measured. The consecutive doses of losartan had a similar antihypertensive response (-11.3 +/- 2.8% by the 100-mg dose). The optimal antiproteinuric response was reached at 100 mg of losartan (-30 +/- 8%). The 50-mg dose (-13 +/- 7%) was less effective, and the 150-mg dose (-28 +/- 8%) was not more effective. A 100-mg dose of losartan is optimal for reduction of proteinuria in nondiabetic patients with nephrotic range proteinuria.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antihypertensive Agents / administration & dosage*
  • Chronic Disease
  • Dose-Response Relationship, Drug
  • Humans
  • Losartan / administration & dosage*
  • Prospective Studies
  • Proteinuria / drug therapy*


  • Antihypertensive Agents
  • Losartan