Losartan in End-Stage Renal Disease (ESRD)

Comparative Effectiveness

• The American Journal of Kidney Diseases and Kidney International suggest that ARBs like losartan have similar renoprotective effects to ACE inhibitors in patients with CKD but with fewer side effects such as cough 1, 2
• In patients with diabetes and albuminuria, ARBs like losartan have demonstrated dose-dependent reduction in the risk of progression of CKD 2

Important Precautions

• The American Journal of Kidney Diseases recommends that dual RAAS blockade (combining losartan with an ACE inhibitor) is not recommended as it increases risk of hyperkalemia and acute kidney injury without improving outcomes 3

Clinical Approach to Using Losartan in ESRD

• The American College of Cardiology suggests assessing blood pressure response regularly, with target based on individual cardiovascular risk 4