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Study of ACEI versus ARB in managing hypertensive overt diabetic nephropathy: long-term analysis.
Kidney Blood Press Res. 2009; 32(4):268-75.KB

Abstract

BACKGROUND

There is, to our knowledge, no study that has directly compared angiotensin-converting enzyme inhibitor (ACEI) with angiotensin receptor blocker (ARB) in hypertensive patients with overt diabetic nephropathy (DNP). We tried to analyze the outcomes of hypertensive patients with overt type 2 DNP who used only ACEIs or ARBs.

METHODS

The patients who had an estimated creatinine clearance <90 ml/min and hypertension or had been using antihypertensive drug(s) at presentation were included in the study. The patients were classified as ACEI group and ARB group.

RESULTS

A total of 100 patients (55 men and 45 women, mean age 61.8 +/- 9.16 years) were included in the study. Mean duration of follow-up was 24.6 +/- 14.1 months. Baseline demographics, biochemical analyses and blood pressures were similar. Renal functions and proteinuria of both groups did not show any significant changes during follow-up. Blood pressure courses were also similar. Although the mean doubling time of creatinine in the ARB group was shorter than the ACEI group, it was not statistically significant. During the follow-up period, 4 patients died (2 in the ACEI group, 2 in the ARB group) and 10 patients were started on dialysis (7 in the ACEI group, 3 in the ARB group). Serum creatinine and the amount of proteinuria were the baseline parameters which were related to the initiation of dialysis.

CONCLUSION

ACEIs and ARBs have similar outcomes in overt DNP. Their renoprotective effects can be observed in spite of uncontrolled hypertension.

Authors+Show Affiliations

Department of Nephrology, Haseki Training and Research Hospital, Istanbul, Turkey. savasozturkdr@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19776644

Citation

Ozturk, Savas, et al. "Study of ACEI Versus ARB in Managing Hypertensive Overt Diabetic Nephropathy: Long-term Analysis." Kidney & Blood Pressure Research, vol. 32, no. 4, 2009, pp. 268-75.
Ozturk S, Sar F, Bengi-Bozkurt O, et al. Study of ACEI versus ARB in managing hypertensive overt diabetic nephropathy: long-term analysis. Kidney Blood Press Res. 2009;32(4):268-75.
Ozturk, S., Sar, F., Bengi-Bozkurt, O., & Kazancioglu, R. (2009). Study of ACEI versus ARB in managing hypertensive overt diabetic nephropathy: long-term analysis. Kidney & Blood Pressure Research, 32(4), 268-75. https://doi.org/10.1159/000239765
Ozturk S, et al. Study of ACEI Versus ARB in Managing Hypertensive Overt Diabetic Nephropathy: Long-term Analysis. Kidney Blood Press Res. 2009;32(4):268-75. PubMed PMID: 19776644.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Study of ACEI versus ARB in managing hypertensive overt diabetic nephropathy: long-term analysis. AU - Ozturk,Savas, AU - Sar,Fuat, AU - Bengi-Bozkurt,Olcay, AU - Kazancioglu,Rumeyza, Y1 - 2009/09/18/ PY - 2009/04/14/received PY - 2009/07/07/accepted PY - 2009/9/25/entrez PY - 2009/9/25/pubmed PY - 2009/12/31/medline SP - 268 EP - 75 JF - Kidney & blood pressure research JO - Kidney Blood Press Res VL - 32 IS - 4 N2 - BACKGROUND: There is, to our knowledge, no study that has directly compared angiotensin-converting enzyme inhibitor (ACEI) with angiotensin receptor blocker (ARB) in hypertensive patients with overt diabetic nephropathy (DNP). We tried to analyze the outcomes of hypertensive patients with overt type 2 DNP who used only ACEIs or ARBs. METHODS: The patients who had an estimated creatinine clearance <90 ml/min and hypertension or had been using antihypertensive drug(s) at presentation were included in the study. The patients were classified as ACEI group and ARB group. RESULTS: A total of 100 patients (55 men and 45 women, mean age 61.8 +/- 9.16 years) were included in the study. Mean duration of follow-up was 24.6 +/- 14.1 months. Baseline demographics, biochemical analyses and blood pressures were similar. Renal functions and proteinuria of both groups did not show any significant changes during follow-up. Blood pressure courses were also similar. Although the mean doubling time of creatinine in the ARB group was shorter than the ACEI group, it was not statistically significant. During the follow-up period, 4 patients died (2 in the ACEI group, 2 in the ARB group) and 10 patients were started on dialysis (7 in the ACEI group, 3 in the ARB group). Serum creatinine and the amount of proteinuria were the baseline parameters which were related to the initiation of dialysis. CONCLUSION: ACEIs and ARBs have similar outcomes in overt DNP. Their renoprotective effects can be observed in spite of uncontrolled hypertension. SN - 1423-0143 UR - https://www.unboundmedicine.com/medline/citation/19776644/Study_of_ACEI_versus_ARB_in_managing_hypertensive_overt_diabetic_nephropathy:_long_term_analysis_ L2 - https://www.karger.com?DOI=10.1159/000239765 DB - PRIME DP - Unbound Medicine ER -