{"doi":"10.1093/ndt/gfv429","title":"Individual long-term albuminuria exposure during angiotensin receptor blocker therapy is the optimal predictor for renal outcome","abstract":null,"journal":"Nephrology Dialysis Transplantation","year":2016,"id":600564,"datarank":0.4335557636844247,"base_score":2.8903717578961645,"endowment":2.8903717578961645,"self_citation_contribution":0.4335557636844247,"citation_network_contribution":0.0,"self_endowment_contribution":0.4335557636844247,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":17,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":29444,"name":"Dick de Zeeuw","orcid":"0000-0003-3434-7777","position":1,"is_corresponding":false},{"id":1539730,"name":"Frank Arjan Holtkamp","orcid":null,"position":2,"is_corresponding":false},{"id":1539731,"name":"David Kenneth Packham","orcid":null,"position":3,"is_corresponding":false},{"id":1539732,"name":"Hiddo J. L. Heerspink","orcid":null,"position":4,"is_corresponding":false},{"id":1539729,"name":"Tobias Felix Kröpelin","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Individual long-term albuminuria exposure during angiotensin receptor blocker therapy is the optimal predictor for renal outcome","abstract":"<h4>Background</h4>Albuminuria reduction due to angiotensin receptor blockers (ARBs) predicts subsequent renoprotection. Relating the initial albuminuria reduction to subsequent renoprotection assumes that the initial ARB-induced albuminuria reduction remains stable during follow-up. The aim of this study was to assess individual albuminuria fluctuations after the initial ARB response and to determine whether taking individual albuminuria fluctuations into account improves renal outcome prediction.<h4>Methods</h4>Patients with diabetes and nephropathy treated with losartan or irbesartan in the RENAAL and IDNT trials were included. Patients with >30% reduction in albuminuria 3 months after ARB initiation were stratified by the subsequent change in albuminuria until Month 12 in enhanced responders (>50% albuminuria reduction), sustained responders (between 20 and 50% reduction), and response escapers (<20% reduction). Predictive performance of the individual albuminuria exposure until Month 3 was compared with the exposure over the first 12 months using receiver operating characteristics (ROC) curves.<h4>Results</h4>Following ARB initiation, 388 (36.3%) patients showed an >30% reduction in albuminuria. Among these patients, the albuminuria level further decreased in 174 (44.8%), remained stable in 123 (31.7%), and increased in 91 (23.5%) patients. Similar albuminuria fluctuations were observed in patients with <30% albuminuria reduction. Renal risk prediction improved when using the albuminuria exposure during the first 12 months versus the initial Month 3 change [ROC difference: 0.78 (95% CI 0.75-0.82) versus 0.68 (0.64-0.72); P < 0.0001].<h4>Conclusions</h4>Following the initial response to ARBs, a large within-patient albuminuria variability is observed. Hence, incorporating multiple albuminuria measurements over time in risk algorithms may be more appropriate to monitor treatment effects and quantify renal risk.","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"26790449","pmcid":null,"openalex_id":null,"authors":[],"funders":[],"total_grants":0,"fwci":null,"citation_percentile":null,"influential_citations":0,"citation_trend":[],"oa_status":"bronze","license":null,"oa_locations":[{"url":"https://academic.oup.com/ndt/article-pdf/31/9/1471/17171906/gfv429.pdf","host_type":"publisher"},{"url":"http://academic.oup.com/ndt/article-pdf/31/9/1471/17171906/gfv429.pdf","host_type":"publisher"}],"fields_of_study":[],"mesh_terms":["Humans","Diabetic Nephropathies","Kidney Failure, Chronic","Albuminuria","Diabetes Mellitus, Type 2","Biphenyl Compounds","Losartan","Tetrazoles","Prognosis","Risk Factors","Renin-Angiotensin System","Adult","Aged","Middle Aged","Female","Male","Angiotensin Receptor Antagonists","Irbesartan"],"keywords":["Nephropathy","Albuminuria","Risk Prediction","Type Ii Diabetes","Raas Blockade"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-07-29T13:29:15.656520Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}