The evolution of treatment guidelines for diabetic nephropathy. Strategies integrate JNC VI, more recent protocols.
In recent years, new drug development and late-breaking research data have put treatment guidelines for diabetic nephropathy in a state of flux. In particular, trials of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), coupled with enhanced understanding of the renin-angiotensin pathway, have influenced recommendations for patient care. Here, Dr Bakris highlights both the steadfast features and the recent refinements of treatment guidelines for diabetic nephropathy. He describes their backing in research findings and outlines practical antihypertensive and renoprotective therapies to curtail risks of nephropathy and cardiovascular disease in patients with diabetes.
Bakris
George L
GL
Deparments of Preventive Medicine and Internal Medicine, Rush Hypertension/Clinical Research Center, Rush-Presbyterian-St Luke's Medical Center, 1700 W Van Buren St, Suite 470, Chicago, IL 60612, USA. gbakris@rush.edu
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003928:Diabetic Nephropathies / Q000150:complications / Q000401:mortality / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D012084:Renin-Angiotensin System / Q000187:drug effects; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents