Reno-Protective Effects of Angiotensin Receptor Blockers in Hypertensive Rodent Models: A systematic review.

Abstract

Background and objective: Essential hypertension is a leading risk factor for chronic kidney disease, yet there is no conclusive evidence that lowering blood pressure alone improves renal outcome measures. Angiotensin-II receptor blockers (ARBs) proposed to have renal-protective effects independent of their antihypertensive effect. This systematic review of animal studies aims to collect available information from the published literature about the ARBs' consequences in murine models and analyze it in a structured way to provide a pre-clinical baseline for future analysis of similar clinical investigations. Methods: Following the PRISMA checklist, we conducted a systematic review for quasi non-randomized controlled studies using PubMed, Embase, Science-Direct, SCOPUS, and Google Scholar to determine the effects of ARBs on kidney functions. Eligible articles report the ARBs' effect on proteinuria, albuminuria, and glomerular filtration rate in murine models of hypertension. Outcomes were present as Mean ± Standard Error of Mean (SEM) with 95% confidence intervals (CIs). Results: This preliminary analysis includes ten out of 56 total eligible articles after quality assessment, reporting twelve renal outcome measures. Two studies showed improvement in CrCl versus one study showing no difference. Four out of five studies showed a reduction in proteinuria compared to the control group. All three studies showed a significant reduction in albuminuria compared to control and other antihypertensives. A study Evaluating BUN showed no difference. Nine outcomes supported the reno-protective effect of ARBs on different hypertensive models with various ARBs and different follow-up durations. Low dose valsartan 10mg/kg was showing no significant effect across two different studies. Conclusion: Preliminary results are encouraging. ARBs contribute to improvement in renal biomarkers in different hypertensive models regardless of their BP-lowering effect.