[Clinical study of the month. Nephroprotective role of angiotensin II receptor antagonists in type 2 diabetes: results of the IDNT and RENAAL trials].
Nephropathy associated with type 2 diabetes mellitus is a rising cause of end-stage renal disease and is a major public health problem. If blocking of the renin angiotensin system has a well established nephroprotective effect in type 1 diabetic nephropathy, this remained to be shown for type 2 diabetes. Two large outcome trials using angiotensin II receptor antagonists (ARA's) in proteinuric chronic renal impairment and hypertensive type 2 diabetic patients have now closed this gap: the Irbesartan Diabetic Nephropathy Trial (IDNT) and the Reduction of Endpoints in NIDDM with Angiotensin II Antagonist Losartan (RENAAL) trial. Both trials showed a significant reduction in the primary pre-specified end-point of death, or worsening of renal function (doubling of serum creatinine) or the development of end-stage renal disease. This effect goes beyond the reduction in blood pressure and makes of ARA's one of the important tools in the treatment of type 2 diabetic nephropathy.
Weekers
L
L
Service de Néphrologie, CHU Sart-Tilman.
Krzesinski
J M
JM
D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents / Q000494:pharmacology*; D003404:Creatinine / Q000378:metabolism; D003928:Diabetic Nephropathies / Q000150:complications / Q000517:prevention & control*; D006801:Humans; D006977:Hypertension, Renal / Q000150:complications; D007676:Kidney Failure, Chronic / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D012084:Renin-Angiotensin System / Q000187:drug effects* / Q000502:physiology; D016896:Treatment Outcome
D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents; D003404:Creatinine
Etude clinique du mois. Rôle néphroprotecteur des antagonistes du récepteur de l'angiotensine II (ARA) dans le diabète de type 2: résultats des études IDNT et RENAAL.