Cited by 7,495Chronic Kidney Disease and DiabetesRenin-Angiotensin System StudiesRenal Diseases and Glomerulopathies

The DOI matches its Crossref record; 41 of the 41 references it cites were found in a registry or an index; 1 of the 20 sources its claims cite were checked for support.

Effects of Losartan on Renal and Cardiovascular Outcomes in Patients with Type 2 Diabetes and Nephropathy

Open access

Abstract

BACKGROUND: Diabetic nephropathy is the leading cause of end-stage renal disease. Interruption of the renin-angiotensin system slows the progression of renal disease in patients with type 1 diabetes, but similar data are not available for patients with type 2, the most common form of diabetes. We assessed the role of the angiotensin-II-receptor antagonist losartan in patients with type 2 diabetes and nephropathy. METHODS: A total of 1513 patients were enrolled in this randomized, double-blind study comparing losartan (50 to 100 mg once daily) with placebo, both taken in addition to conventional antihypertensive treatment (calcium-channel antagonists, diuretics, alpha-blockers, beta-blockers, and centrally acting agents), for a mean of 3.4 years. The primary outcome was the composite of a doubling of the base-line serum creatinine concentration, end-stage renal disease, or death. Secondary end points included a composite of morbidity and mortality from cardiovascular causes, proteinuria, and the rate of progression of renal disease. RESULTS: A total of 327 patients in the losartan group reached the primary end point, as compared with 359 in the placebo group (risk reduction, 16 percent; P=0.02). Losartan reduced the incidence of a doubling of the serum creatinine concentration (risk reduction, 25 percent; P=0.006) and end-stage renal disease (risk reduction, 28 percent; P=0.002) but had no effect on the rate of death. The benefit exceeded that attributable to changes in blood pressure. The composite of morbidity and mortality from cardiovascular causes was similar in the two groups, although the rate of first hospitalization for heart failure was significantly lower with losartan (risk reduction, 32 percent; P=0.005). The level of proteinuria declined by 35 percent with losartan (P<0.001 for the comparison with placebo). CONCLUSIONS: Losartan conferred significant renal benefits in patients with type 2 diabetes and nephropathy, and it was generally well tolerated.

Overview

Integrity signals

Registry

Crossref · 10.1056/nejmoa011161

Cites

41 of 41 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

1 of 20 cited sources checked · 1 supported · 0 flagged

Show all 49 claims

  • It may state two separate claims as one. 14
  • Probably not a substantial claim. 16
  • The quote only partly states this claim. 1
27 of 27
  • The paper relies on this without support.

    Diabetic nephropathy is the leading cause of end-stage renal disease.

    “Diabetic nephropathy is the leading cause of end-stage renal disease.”
  • The paper relies on this without support.

    Type 2 diabetes is the most common form of diabetes.

    “type 2, the most common form of diabetes”
  • The paper relies on this without support.

    Similar data on interruption of the renin-angiotensin system are not available for patients with type 2 diabetes.

    “similar data are not available for patients with type 2, the most common form of diabetes”
  • The paper relies on this without support.

    Postponing end-stage renal disease in patients with type 2 diabetes remains an elusive goal.

    “postponing end-stage renal disease in patients with type 2 diabetes, the leading cause of chronic renal failure in many countries, remains an elusive goal”
  • The paper relies on this without support.

    Type 2 diabetes is the leading cause of chronic renal failure in many countries.

    “type 2 diabetes, the leading cause of chronic renal failure in many countries”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Mean follow-up of 3.4 years is not 42 months

    Minor

    At 12 months per year, 3.4 years is 40.8 months, not 42 months. Forty-two months is 3.5 years.

    Reported 42 · recomputed 40.8

  • Patients with prior heart failure were both excluded and included

    Minor

    The eligibility criteria excluded anyone with a history of heart failure before enrollment, but the paper later says 88 patients had preexisting heart failure at randomization. This affects the description of the population used for the heart-failure analysis.

2 of 2

Citations

Cites

Flagged first, then by citations

Research works printed but not linked: 5

  1. Black HR, 1999, J Hypertens, 17, S3
  2. Levey AS, 2000, J Am Soc Nephrol, 11, 155A
  3. Walker WG, 1992, J Am Soc Nephrol, 3, 339
  4. Estacio RO, 2000, Diabetes Care, 23, B54
  5. Bauer JH, Reams GP. Antihypertensive drugs. In: Brenner BM, ed. The kidney. 6th ed. Philadelphia: W.B. Saunders, 2000:2253-97.

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Metadata

Authors
Brenner, B. M., Cooper, M. E., de Zeeuw, D., Keane, W. F., Mitch, W. E., Parving, H.-H., Remuzzi, G., Snapinn, S. M., Zhang, Z., & Shahinfar, S.
Affiliations
  • Brigham and Women's Hospital (US)
  • The University of Melbourne (AU)
  • Hennepin County Medical Center (US)
  • Emory University (US)
  • Mario Negri Institute for Pharmacological Research (IT)
  • Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
Venue
New England Journal of Medicine
Published
2001-09-20
Volume
345
Issue
12
Pages
861-869
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2056976690
Cited by
7,493
References
37
Citations by year
2026: 180 · 2025: 233 · 2024: 211 · 2023: 248 · 2022: 235 · 2021: 240 · 2020: 263 · 2019: 204 · 2018: 212 · 2017: 233 · 2016: 243 · 2015: 249 · 2014: 289 · 2013: 288 · 2012: 341
FWCI
280.94
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (publishedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
  • RECERCAT (Consorci de Serveis Universitaris de Catalunya) (submittedVersion, public-domain)
Topics
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
  • Health Sciences › Medicine › Nephrology › Renal Diseases and Glomerulopathies
Keywords
losartan, type 2 diabetes, diabetic nephropathy, angiotensin receptor blockers, renin-angiotensin system blockade, end-stage renal disease, kidney disease progression, proteinuria, cardiovascular morbidity and mortality, heart failure hospitalization, serum creatinine doubling, antihypertensive therapy
MeSH terms
Adult, Aged, Antihypertensive Agents, Cardiovascular Diseases, Creatine, Creatinine, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Double-Blind Method, Female, Humans, Hypertension, Kidney Failure, Chronic, Male, Middle Aged, Proteinuria, Disease Progression, Losartan, Angiotensin Receptor Antagonists

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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