PMID: 15369420Sep 17, 2004Paper

Emerging trends for prevention and treatment of diabetic nephropathy: blockade of the RAAS and BP control

Journal of Managed Care Pharmacy : JMCP
Lawrence G Hunsicker

Abstract

Diabetic nephropathy (DN) is the leading cause of end-stage renal disease (ESRD), and it affects 30% of patients with type 1 diabetes mellitus (DM) and 20% of patients with type 2 DM. Clinical features in both types of DM are similar and are characterized by an underlying abnormality of the microcirculation, manifested by both retinopathy and nephropathy. Clinical hallmarks of DN include elevated blood pressure (BP) and elevated urinary protein excretion. Treatment consists of maintaining BP at <130/85 mm Hg in patients without proteinuria and <125/75 mm Hg in patients with microalbuminuria or overt DN. In addition, agents that inhibit the renin-angiotensin-aldosterone system (RAAS) have been found to be effective in reducing the risk of progression to DN, a result independent of their antihypertensive effect. The earlier Collaborative Study Group (CGS) trial demonstrated that the angiotensin-converting enzyme (ACE) inhibitor captopril lowered BP and provided renal protection in type 1 diabetic kidney disease beyond that attributable to the BP change. The Irbesartan Diabetic Nephropathy Trial (IDNT) studied the effect of the angiotensin receptor blocker (ARB) irbesartan on the reduction of BP, urinary protein excretion, and pro...Continue Reading

Citations

Oct 14, 2005·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Wim Van BiesenNorbert Lameire
Jun 17, 2009·Journal of Cardiovascular Pharmacology·Pitchai BalakumarMadhu B Anand-Srivastava
Jul 14, 2021·British Journal of Pharmacology·Md Abdul Hye KhanJohn D Imig
Jun 30, 2009·Current Medical Research and Opinion·V G AthyrosUNKNOWN INDEED Collaborative Group

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