Prevention of microalbuminuria in patients with type 2 diabetes: what do we know?
Cardiovascular and chronic kidney disease are epidemic throughout industrialized societies. Diabetes leads to premature cardiovascular disease and is regarded by many as the most common etiological factor for chronic kidney disease. Because most studies of blood-pressure lowering agents in people with diabetes and hypertension have been conducted in individuals who already have some target organ damage, it is unclear whether earlier intervention could prevent or delay the onset of renal or systemic vascular disease. In early disease there is only a low possibility of observing cardiovascular or renal events; thus intervention trials in this population must rely on disease markers such as microalbuminuria. Accordingly, the authors review the evidence to support the use of microalbuminuria as a disease marker in diabetic patients based on its strong association with renal and cardiovascular events, and discuss recent trials that examine the impact of preventing or delaying the onset of microalbuminuria.
Ruilope
Luis
L
Hypertension Unit, Hospital 12 de Octubre, Madrid, Spain. ruilope@ad-hocbox.com
Izzo
Joseph
J
Haller
Hermann
H
Waeber
Bernard
B
Oparil
Suzanne
S
Weber
Michael
M
Bakris
George
G
Sowers
James
J
D000419:Albuminuria / Q000209:etiology / Q000517:prevention & control*; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000209:etiology / Q000517:prevention & control*; D018450:Disease Progression; D004730:Endothelium, Vascular; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D012084:Renin-Angiotensin System / Q000187:drug effects; D012307:Risk Factors; D013777:Tetrazoles / Q000627:therapeutic use
D047228:Angiotensin II Type 1 Receptor Blockers; D007093:Imidazoles; D013777:Tetrazoles; C437965:olmesartan