Outcome studies in diabetic nephropathy.
Outcome studies in diabetic nephropathy have focused on strategies to prevent progression of diabetic nephropathy, the leading cause of ESRD in the United States. Once diabetics develop overt nephropathy, prognosis is poor. Risk factors for diabetic nephropathy are discussed, and include hyperglycemia, hypertension, angiotensin II, proteinuria, dyslipidemia, smoking, and anemia. Major outcomes as well as outcome studies in diabetic nephropathy for patients with microalbuminuria and macroalbuminuria are reviewed. Furthermore, the role of therapy with angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, and mineralocorticoid receptor antagonists as well as selected combination therapy are discussed. Recommendations for therapy with ace inhibitors and angiotensin II receptor blockers are made based on this evidence.
Mohanram
Anupama
A
University of Texas Southwestern Medical Center Dallas, Dallas, TX 75390-8856, USA.
Toto
Robert D
RD
D000419:Albuminuria / Q000188:drug therapy / Q000453:epidemiology; D000740:Anemia / Q000453:epidemiology; D000804:Angiotensin II / Q000378:metabolism; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001713:Biphenyl Compounds / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology; D006949:Hyperlipidemias / Q000453:epidemiology; D006977:Hypertension, Renal / Q000453:epidemiology; D000077405:Irbesartan; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D017063:Outcome Assessment, Health Care; D011507:Proteinuria / Q000453:epidemiology; D012084:Renin-Angiotensin System; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013777:Tetrazoles / Q000627:therapeutic use
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D001713:Biphenyl Compounds; D002121:Calcium Channel Blockers; D013777:Tetrazoles; D000804:Angiotensin II; D000077405:Irbesartan