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Practical Diabetes Care, 3rd Ed., Excerpt #13: Diabetic Renal Disease Part 2 of 5

Apr 22, 2015
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Angiotensin blockade treatment

There are relatively few large-scale studies of angiotensin blockade treatment in microalbuminuric type 2 patients. ACE inhibitors and ARBs are equally effective in reducing albuminuria and slowing the decline in eGFR; trialled agents include enalapril 20 mg daily and telmisartan 80 mg daily. IRMA-2 (2001) found that full-dose irbesartan (300 mg daily) was more likely to prevent progression to macroalbuminuria over 2 years than 150 mg daily. Full doses of any agents should be used in this situation.

 

References:

  1. Burrows NR, Li Y, Geiss LS. Incidence of treatment for end-stage renal disease among individuals with diabetes in the U.S. continues to decline. Diabetes Care 2010;33:73–7. PMID: 20040673.
  2. Adler AI, Stevens RJ, Manley SE, Bilous RW, Cull CA, Holman RR. Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int 2003;63:225–32. PMID: 12472787.
  3. Pham TT, Sim JJ, Kujubu DA, Liu IL, Kumar VA. Prevalence of nondiabetic renal disease in diabetic patients. Am J Nephrol 2007;27:322–8. PMID: 17495429.
  4. Romão JE, Haiashi AR, Elias RM et al. Positive acute-phase inflammatory markers in different stages of chronic kidney disease. Am J Nephrol 2006;26: 59–66. PMID: 16508248.
  5. Houlihan CA, Tsalamandris C, Akdeniz A, Jerums G. Albumin to creatinine ratio: a screening test with limitations. Am J Kidney Dis 2002;39:1183–9. PMID: 12046029.
  6. Stoycheff N, Stevens LA, Schmid CH et al. Nephrotic syndrome in diabetic kidney disease: an evaluation and update of the definition. Am J Kidney Dis 2009;54:840–9. PMID: 19556043.
  7. Fonseca V, Thomas M, Katrak A, Sweny P, Moorhead JF. Can urinary thyroid hormone loss cause hypothyroidism? Lancet 1991;338:475–6. PMID: 1678446.
  8. Bilous R, Chaturvedi N, Sjølie AK et al. Effect of candesartan on microalbuminuria and albumin excretion rate in diabetes: three randomized trials. Ann Intern Med 2009;151:11–20. PMID: 19451554.
  9. Ruggenenti P, Fassi A, Ilieva AP et al. Preventing microalbuminuria in type 2 diabetes. Bergamo Nephrologic Diabetes Complications Trial (BENEDICT) investigators. N Engl J Med 2004;351:1941–51. PMID: 15516697.
  10. Perkins BA, Ficociello LH, Silva KH, Finkelstein DM, Warram JH, Krolewski AS. Regression of microalbuminuria in type 1 diabetes. N Engl J Med 2003;348:2285–93. PMID: 12788992.
  11. Gæde P, Lund-Andersen H, Parving HH, Pederson O. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med 2008;358:580–91. PMID: 18256393.
  12. House AA, Eliasziw M, Cattran DC et al. Effect of B-vitamin therapy on progression of diabetic nephropathy: a randomized controlled trial. JAMA 2010;303:1603–9. PMID: 20424250.
  13. The ASTRAL Investigators. Revascularization versus medical therapy for renal-artery stenosis. N Engl J Med 2009;361:1953–62. PMID: 19907042.
  14. Schjoedt KJ, Astrup AS, Persson F et al. Optimal dose of lisinopril for renoprotection in type 1 diabetic patients with diabetic nephropathy: a randomised crossover trial. Diabetologia 2009;52:46–9. PMID: 18974967.
  15. Parving HH, Persson F, Lewis JB, Lewis EJ, Hollenberg NK. Aliskiren combined with losartan in type 2 diabetes and nephropathy. AVOID Study Investigators. N Engl J Med 2008;358:2433–46. PMID: 18525041.
  16. Drechsler C, Krane V, Ritz E, März W, Wanner C. Glycemic control and cardiovascular events in diabetic hemodialysis patients. Circulation 2009;120:2421–8. PMID: 19948978.
  17. Agarwal R. Blood pressure and mortality among hemodialysis patients. Hypertension 2010;55:762–8. PMID: 20083728.
  18. Colhoun HM, Betteridge DJ, Durrington PN et al. Effects of atorvastatin on kidney outcomes and cardiovascular disease in patients with diabetes: an analysis from the Collaborative Atorvastatin Diabetes Study (CARDS). Am J Kidney Dis 2009;54:810–19. PMID: 19540640.
  19. Gal-Moscovici A, Sprague SM. Bone health in chronic kidney disease–mineral and bone disease. Adv Chronic Kidney Dis 2007;14:27–36. PMID: 17200041.
  20. New JP, Aung T, Baker PG et al. The high prevalence of unrecognized anaemia in patients with diabetes and chronic kidney disease: a population-based study. Diabetic Med 2008;25:564–9. PMID: 18445169.
  21. Agarwal R, Rizkala AR, Bastani B, Kaskas MO, Leehey DJ, Besarab A. A randomized controlled trial of oral versus intravenous iron in chronic kidney disease. Am J Nephrol 2006;26:445–54. PMID 17035697.
  22. Shapiro AMJ, Ricordi C, Hering BJ et al. International trial of the Edmonton protocol for islet transplantation. N Engl J Med 2006;355:1318–30. PMID: 17005949.

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David Levy, MD, FRCP, Consultant Physician, Gillian Hanson Centre, Whipps Cross University Hospital; Honorary Senior Lecturer
Queen Mary University of London London, UK

This edition first published 2011, © 2011 by David Levy. 1st edition 1998 (Greenwich Medical Media/Cambridge University Press) 2nd edition 2006 (Altman Publications)