{"id":"9b7ae6fb9590","type":"article","url":"https://hartvaat.nl/2017/08/01/foliumzuurtherapie-en-nieuwe-proteinurie-bij-chinese-hypertensieve-patienten-csp/","title":"Foliumzuurtherapie en nieuwe proteïnurie bij Chinese hypertensieve patiënten: CSPPT-subanalyse","title_en":"Effects of Folic Acid Therapy on the New-Onset Proteinuria in Chinese Hypertensive Patients: A Post Hoc Analysis of the Renal Substudy of CSPPT (China Stroke Primary Prevention Trial).","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","internist"],"tags":["flow-trial"],"journal":"Hypertension (Dallas, Tex. : 1979)","doi":"10.1161/HYPERTENSIONAHA.117.09404","source_url":"https://doi.org/10.1161/HYPERTENSIONAHA.117.09404","authors":["Youbao Li","Min Liang","Guobao Wang","Binyan Wang","Mingli He","Genfu Tang","Delu Yin","Xin Xu","Yong Huo","Yimin Cui","Fan Fan Hou","Xianhui Qin"],"significance":5,"published":"2017-08-01","source_date":"2017-08-01","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/raas-blokkade-bij-nierziekte/","https://hartvaat.nl/kennis/hypertensie/esc-richtlijn-hypertensie-2024/"],"congress":"","summary_en":"This CSPPT post-hoc analysis showed that folic acid supplementation added to enalapril reduces new-onset proteinuria in Chinese hypertensive patients, suggesting a renoprotective synergy between RAAS inhibition and folate.","created":"2026-07-03T10:26:48Z","updated":"2026-07-03T13:26:06Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Post-hoc analyse van de renale substudie van CSPPT naar het effect van foliumzuursuppletie op het ontstaan van proteïnurie bij hypertensieve patiënten.","abstract_original":"UNLABELLED: We aimed to test the hypothesis that treatment with enalapril and folic acid is more effective in preventing new-onset proteinuria than enalapril alone among hypertensive patients. This is a post hoc analysis of the renal substudy of the CSPPT (China Stroke Primary Prevention Trial). A total of 13 071 eligible participants without proteinuria were randomized to receive a double-blind daily treatment of a single tablet containing 10-mg enalapril and 0.8-mg folic acid (n=6511) or 10-mg enalapril alone (n=6560). The primary outcome was new-onset proteinuria, defined as a urine dipstick reading of ≥1+ at the exit visit. Secondary outcomes included a composite of the primary outcome and all-cause death and the annual rate of estimated glomerular filtration rate decline. After a median 4.4 years of treatment, the primary event occurred in 213 (3.9%) and 188 (3.5%) participants, respectively, in the enalapril and the enalapril-folic acid group (odds ratio, 0.90; 95% confidence interval, 0.74-1.11). However, among participants with diabetes mellitus at baseline, folic acid therapy resulted in a significant reduction in the risk for the primary event (3.7% in the enalapril-folic acid group versus 7.4% in the enalapril group; odds ratio, 0.48; 95% confidence interval, 0.29-0.81) and the composite event (odds ratio, 0.62; 95% confidence interval, 0.42-0.92) and a 55% slower annual rate of estimated glomerular filtration rate decline (0.5% versus 1.1% per year; P=0.002). Among those without diabetes mellitus at baseline, there were no between-group differences in all the outcomes. In conclusion, enalapril-folic acid therapy, compared with enalapril alone, significantly reduced the development of proteinuria in diabetic patients with hypertension. CLINICAL TRIAL REGISTRATION: URL: http://www.ClinicalTrials.gov. Unique identifier: NCT00794885."}