title: Does antihypertensive treatment with renin-angiotensin system inhibitors prevent the development of diabetic kidney disease?
abstract: BACKGROUND
  Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease worldwide. Renin-angiotensin system (RAS) inhibitors are the first-line treatment for diabetic patients with hypertension. However, whether RAS inhibitors prevent the development of DKD remains controversial. We conducted a retrospective cohort study quantifying the preventive effect of antihypertensive treatment with RAS inhibitors on DKD, using data from specific health check-ups and health insurance claims.
  
  
  METHODS
  The study subjects were 418 patients with diabetes and hypertension, drawn from health insurance societies located in Fukuoka and Shizuoka prefectures in Japan. The subjects were divided into three groups, according to the type of antihypertensive treatment they received. They were then compared in terms of the development of DKD, using the diagnostic codes from ICD-10.
  
  
  RESULTS
  Thirty subjects (6.2%) developed DKD during the study period between April 2011 and September 2013. RAS inhibitor treated group showed a significantly lower risk of DKD [adjusted odds ratio (AOR) = 0.35; 95% confidential interval (CI): 0.16-0.76] compared with the no treatment group.
  
  
  CONCLUSIONS
  We conclude that antihypertensive treatment with RAS inhibitors is potentially useful for preventing the development of DKD.
authors.affiliation: Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. hirokim@cc.saga-u.ac.jp.|Department of Social and Environmental Medicine, Faculty of Medicine, Saga University, Saga, Japan. hirokim@cc.saga-u.ac.jp.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Miyazaki
authors.affiliation: Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. babazono@hcam.med.kyushu-u.ac.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Babazono
authors.affiliation: Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. takumi.nishi.19860614@gmail.com.
authors.forename: Takumi
authors.initials: T
authors.lastname: Nishi
authors.affiliation: Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. toshikimaeda1216@gmail.com.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Maeda
authors.affiliation: Department of Hygiene and Preventive Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan. imatoh@cis.fukuoka-u.ac.jp.
authors.forename: Takuya
authors.initials: T
authors.lastname: Imatoh
authors.affiliation: Department of Social and Environmental Medicine, Faculty of Medicine, Saga University, Saga, Japan. ichiba@cc.saga-u.ac.jp.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Ichiba
authors.affiliation: Medical Research Center, Faculty of Medicine, Fukuoka University, Fukuoka, Japan. une@cis.fukuoka-u.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Une
mesh_terms: D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D048909:Diabetes Complications / Q000188:drug therapy* / Q000517:prevention & control; D003928:Diabetic Nephropathies / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D007676:Kidney Failure, Chronic / Q000188:drug therapy* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D012084:Renin-Angiotensin System / Q000187:drug effects*; D012189:Retrospective Studies
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents