Blood pressure in diabetic nephropathy--current controversies.
Hypertension has been recognized as an early and constant feature of diabetic nephropathy, but recent studies also suggest that a genetic predisposition to hypertension is an important risk factor for diabetic nephropathy. Antihypertensive treatment attenuates progression in diabetic nephropathy, but there is increasing evidence that very early treatment and very low target blood pressures should be implemented. There is also evidence for local activation of the renin system in the kidney as a result of hyperglycaemia. Apart from blood pressure, proteinuria should be monitored and dosing of ACE inhibitors should be guided, also by reduction of protein excretion.
Ritz
E
E
Department of Internal Medicine, Ruperto Carola University, Heidelberg, Germany. Prof.E.Ritz@T-online.de
Rychlík
I
I
Schömig
M
M
Wagner
J
J
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D003928:Diabetic Nephropathies / Q000150:complications / Q000188:drug therapy / Q000235:genetics / Q000503:physiopathology*; D020022:Genetic Predisposition to Disease; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology; D016032:Randomized Controlled Trials as Topic
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents