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Angiotensin‐Converting Enzyme Inhibitors or Angiotensin II Receptor Blockers for Prevention and Treatment of Nephropathy Associated with Type 2 Diabetes Mellitus
Author(s) -
Hughes David B.,
Britton Mark L.
Publication year - 2005
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.2005.25.11.1602
Subject(s) - albuminuria , medicine , microalbuminuria , diabetic nephropathy , enalapril , nephropathy , diabetes mellitus , type 2 diabetes mellitus , endocrinology , angiotensin converting enzyme , urology , pharmacology , blood pressure
Renal complications resulting from type 2 diabetes mellitus are costly and common. Finding optimal therapy is important for the prevention and management of diabetic nephropathy. Research has focused on antihypertensive agents that modify the renin‐angiotensin‐aldosterone system. Because of their effects on the glomerulus, angiotensin‐converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) have been studied as interventions at various stages of diabetic nephropathy. The ACE inhibitors may delay the progression to microalbuminuria and then clinical albuminuria. The ARBs decrease albuminuria in patients with microalbuminuria and decrease adverse renal events, specifically the progression to end‐stage renal disease in patients with clinical albuminuria and hypertension. Limited data suggest that combination therapy with ACE inhibitors and ARBs may slow the progression of microalbuminuria to clinical albuminuria. Because of the variability in degree of albuminuria evaluated and in study designs (numbers of patients, study duration, drug dosages, and outcomes measured), a detailed review of the available literature about ACE inhibitors and ARBs in the prevention or treatment of diabetic nephropathy may provide insight to clinicians.