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Abstract: TH-PO857

Leukotriene Antagonist Use Is Associated With Less Albuminuria and Lower Systolic Blood Pressure in Adults

Session Information

Category: CKD (Non-Dialysis)

  • 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention

Authors

  • Lai, Jennifer Mai, University of Colorado Denver School of Medicine, Aurora, Colorado, United States
  • Furgeson, Seth B., University of Colorado Denver School of Medicine, Aurora, Colorado, United States
  • Bjornstad, Petter, University of Colorado Denver School of Medicine, Aurora, Colorado, United States
  • You, Zhiying, University of Colorado Denver School of Medicine, Aurora, Colorado, United States
  • Tommerdahl, Kalie L., University of Colorado Denver School of Medicine, Aurora, Colorado, United States
  • Kendrick, Jessica B., University of Colorado Denver School of Medicine, Aurora, Colorado, United States
Background

Proinflammatory mediators known as leukotrienes have been implicated in the development of both chronic kidney disease (CKD) and cardiovascular disease (CVD). Leukotrienes cause endothelial dysfunction which increases glomerular permeability to albumin and causes vascular dysfunction leading to CVD. We hypothesized that the use of montelukast in adults would associate with less albuminuria and lower systolic blood pressure (SBP).

Methods

Participant data from a total of 51,111 adults was extracted from NHANES 1999-2018 and stratified by montelukast prescription status. We evaluated baseline urine albumin to creatinine ratio (ACR) (mg/g), estimated glomerular filtration rate (eGFR) (mL/min/1.73m2), CKD (defined as urine ACR >30 mg/g or eGFR <60 mL/min/1.73m2), and SBP (mmHg) in participants taking montelukast vs. participants not taking montelukast. Urine ACR was log transformed prior to analysis due to positive skew. Regression analyses were used to examine the association between montelukast use and outcomes.

Results

We identified participants taking montelukast (N=434) and compared them to participants not taking montelukast (N=50,677). The mean age and eGFR were 47.2 ± 19 years and 96.6 ± 23.2 mL/min/1.73m2, respectively. Participants taking montelukast were older, had a higher prevalence of diabetes and hypertension, and had a lower eGFR. After adjustment for demographics, diabetes status, hypertension, body mass index (BMI), eGFR, and use of an ACE inhibitor or angiotensin receptor blocker, montelukast use associated with lower urine ACR (Table). Montelukast use did not associate with eGFR or CKD. After adjustment for demographics, diabetes status, BMI, hypertension, eGFR, urine ACR and use of anti-hypertensive medications, montelukast use associated with lower SBP.

Conclusion

Participants taking montelukast had significantly lower albuminuria and SBP compared to participants not taking montelukast. Leukotriene inhibition may represent a promising avenue for future treatment of CKD and CVD.

Montelukast Use vs. No Useβ-estimate (95% CI)P-value
Urine ACR-0.13 (-0.22 to -0.04)0.005
eGFR-0.50 (-2.1 to 1.05)0.51
SBP-1.98 (-3.82 to -0.11)0.038
 Odds Ratio (95% CI)P-value
CKD0.89 (0.66 to 1.21)0.45

Funding

  • NIDDK Support