Treatment of type 2 diabetic nephropathy by blockade of the renin-angiotensin system: a comparison of angiotensin-converting-enzyme inhibitors and angiotensin receptor antagonists.
Type 2 diabetes is the most prevalent form of diabetes mellitus worldwide and associated diabetic nephropathy is the most common cause of end-stage renal disease in the USA. Lowering blood pressure and controlling glucose slows the progression to end-stage renal disease or death. Although angiotensin-converting-enzyme inhibitors reduce proteinuria, their effects to slow progression to end-stage renal disease have not been clearly demonstrated in type 2 diabetic nephropathy. Recent clinical trials with angiotensin AT(1) receptor antagonists demonstrate that they reduce proteinuria, stabilize renal function and slow the progression of nephropathy to end-stage renal disease in patients with type 2 diabetes. These are significant benefits beyond those associated with conventional therapy and blood pressure control.
Hsueh
Willa A
WA
Department of Medicine, Division of Endocrinology, Diabetes and Hypertension, University of California Los Angeles, Warren Hall, 900 Veteran Avenue, Suite 24-130, Los Angeles, CA 90024, USA. WHsueh@mednet.ucla.edu
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000201:enzymology / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000201:enzymology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy* / Q000201:enzymology; D012084:Renin-Angiotensin System / Q000187:drug effects* / Q000502:physiology
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors