Angiotensin-converting enzyme inhibitors and progression of diabetic nephropathy
Article Abstract:
Diabetic nephropathy is characterized by elevated urinary excretion of the protein albumin, high blood pressure and eventually kidney failure. Previous studies have found that maintaining normal blood pressure slows progress of diabetic nephropathy. However, some recent studies on angiotensin-converting enzyme (ACE) inhibitors, which are used to treat high blood pressure, have suggested that their effects on kidney function are independent of their effects on blood pressure. In the first large study on the effects of ACE inhibitors in non-insulin dependent diabetics with normal blood pressure, ACE inhibitors maintained kidney function without lowering blood pressure. This finding is consistent with those from similar studies on insulin-dependent diabetics. Because diuretics and beta-blockers are preferable to ACE inhibitors in the treatment of high blood pressure, the use of ACE inhibitors should be restricted to diabetics with normal blood pressure until more research has been done.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1993
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Long-term stabilizing effect of angiotensin-converting enzyme inhibition on plasma creatinine and on proteinuria in normotensive type II diabetic patients
Article Abstract:
Angiotensin-converting enzyme inhibitors may slow the development of kidney disease in patients with non-insulin dependent diabetes. Angiotensin-converting enzyme inhibitors are used to treat high blood pressure. Most evidence suggests that controlling high blood pressure is the best means of inhibiting kidney disease in these patients. Of 94 non-insulin dependent diabetics, 49 took the angiotensin-converting enzyme inhibitor enalapril and 45 took placebo. Urinary excretion of the protein albumin, which is an indicator of kidney function, remained fairly constant over five years among patients taking enalapril but significantly increased among patients taking placebo. Kidney function remained unchanged for the first two years among patients taking enalapril and then declined about 1% over the next three years. Among patients taking placebo, kidney function steadily declined about 2% every year.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1993
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The effect of ACE inhibitors on kidney function in patients with type 1 diabetes
Article Abstract:
ACE inhibitors may prevent kidney damage in diabetics, according to studies covering 646 patients with type 1 diabetes and microalbuminuria. Microalbuminuria means their urine contained small amounts of albumin, which is a sign of kidney damage.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 2001
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