[Primary cardiorenal prevention in patients with type-2 diabetes. The Roadmap study].
The incidence of type-2 diabetes is increasing throughout the world. By 2010, 350 million people will have this disease. Microalbuminuria is present in more than one third, for some at diabetes diagnosis. Rather than a complication, it is an indication of a vascular disorder that is part of the metabolic syndrome. 25% will develop end-stage kidney failure. Several studies have identified microalbuminuria or proteinuria as an independent cardiovascular risk factor. Others have shown that antihypertensive treatments acting on the renin-angiotensin system (ACE inhibitors, ARBs agents) can reduce the progression of nephropathy in people with hypertension, type 2 diabetes and microalbuminuria. The "nephroprotective" effects of these drug classes, beyond their role in blood-pressure reduction, are suggested by modifications in renal structure and protein expression. But no study has so far examined their value in primary prevention in persons with type 2 diabetes without--but at risk of developing--microalbuminuria. The Roadmap study (Randomized Olmesartan And Diabetes Microalbuminuria Prevention Study) of primary prevention has as its objective measurement of the impact of ARBs (olmesartan 40 mg/d) treatment on renal outcome in 4400 patients with type 2 diabetes without microalbuminuria. Follow-up of this placebo-controlled study will last for 5 years. Conducted in 200 European centers, its results are expected for 2012.
Halimi
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Secteur diabétologie nutrition, Dune (département uro-néphro-endocrinologie), CHU de Grenoble. SHalimi@chu-grenoble.fr
D000328:Adult; D000419:Albuminuria / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D015415:Biomarkers; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D003928:Diabetic Nephropathies / Q000517:prevention & control*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000209:etiology; D008297:Male; D015201:Meta-Analysis as Topic; D024821:Metabolic Syndrome / Q000175:diagnosis; D015337:Multicenter Studies as Topic; D010919:Placebos; D011322:Primary Prevention; D016032:Randomized Controlled Trials as Topic; D051381:Rats; D011919:Rats, Inbred Strains; D012307:Risk Factors; D012737:Sex Factors; D013777:Tetrazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
D047228:Angiotensin II Type 1 Receptor Blockers; D015415:Biomarkers; D006442:Glycated Hemoglobin; D007093:Imidazoles; D010919:Placebos; D013777:Tetrazoles; C437965:olmesartan