Renoprotection and renin-angiotensin system blockade in diabetes mellitus

American Journal of Hypertension
L M Ruilope

Abstract

Diabetic nephropathy is the most common cause of end-stage renal disease (ESRD) in the United States, and accounts for 35% of all the patients with ESRD entering a dialysis program; 63% of patients with diabetic nephropathy have type II diabetes mellitus. Hypertension is a major risk factor for renal disease and is common in people with diabetes mellitus. Strategies for preventing the progression of renal failure in patients with diabetes mellitus include glycemic control, and control of blood pressure. Blocking the renin-angiotensin system (RAS) slows the progression of established diabetic nephropathy in type I diabetes mellitus, and inhibiting angiotensin II formation retards or impedes the progression from microalbuminuria to established diabetic nephropathy (macroproteinuria) in people with type I diabetes mellitus. The situation could be the same for people with type II diabetes mellitus. The ability of RAS blockade using irbesartan, an AT1 angiotensin II receptor antagonist, to slow the progression in renal failure has been compared with that of the calcium channel blocker amlodipine and placebo in a pilot study. The results suggest that blockade of the RAS, in this case with irbesartan, is at least equivalent to calcium...Continue Reading

Citations

Jun 6, 2002·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Makoto MizunoHiroyuki Koike
Nov 1, 2007·International Journal of Clinical Practice·M Volpe
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Jul 28, 2001·Diabetes Technology & Therapeutics·G Boner, M E Cooper
Mar 20, 2003·Current Diabetes Reports·D A Price, N K Hollenberg
May 1, 2004·International Journal of Clinical Practice·L M Ruilope
Aug 10, 2005·Expert Opinion on Pharmacotherapy·Jose Antonio García-DonaireLuis Miguel Ruilope
Mar 23, 2011·Proceedings of the Japan Academy. Series B, Physical and Biological Sciences·Takashi Oite
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Jan 15, 2005·Antioxidants & Redox Signaling·Giovanni DavìCarlo Patrono
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Jun 6, 2012·European Journal of Pharmacology·Sen ZhangXiaoguang Chen
Mar 7, 2007·Diabetes Research and Clinical Practice·José A García Donaire, Luis M Ruilope

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