Angiotensin blockade in type 2 diabetic renal disease.
The available evidence on renal protection in type 2 diabetes mellitus favors the administration of an angiotensin receptor blocker (ARB) more than that of an angiotensin converting enzyme inhibitor (ACEi). This evidence is based on recent studies showing that losartan and irbesartan can prevent the development of overt diabetic nephropathy in microalbuminuric type 2 diabetic patients as well as slow the velocity of progression to end-stage renal disease in patients with overt type 2 diabetic nephropathy. These studies do not deny the possibility that ACEi are equally effective, but studies of an adequate magnitude are lacking. These findings on ARB administration do not preclude the importance of strict control of blood pressure and proteinuria and/or albuminuria to avoid or retard renal damage in type 2 diabetic patients.
Ruilope
Luis Miguel
LM
Unidad de Hipertensión, Hospital 12 de Octubre, Madrid, Spain. Luis_M_Ruilope@teleline.es
Luño
José
J
D000804:Angiotensin II / Q000378:metabolism*; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002986:Clinical Trials as Topic; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control*; D018450:Disease Progression; D019317:Evidence-Based Medicine; D006801:Humans; D012084:Renin-Angiotensin System / Q000187:drug effects*; D016896:Treatment Outcome
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D000804:Angiotensin II