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August 11, 2009Bangladesh Medical Research Council BulletinOpen Access

Effect of enalapril and losartan on proteinuria in type 2 diabetic nephropathy patients

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Why the study?

Does enalapril reduce proteinuria compared to losartan in patients with type 2 diabetic nephropathy?

Population

18 patients with type 2 diabetic nephropathy (proteinuria ≥ 0.5 gm/day and serum creatinine <3 mg/dL)

Comparison

Enalapril 5-40 mg/day in increasing dose for 16… vs Losartan 25-200 mg/day in increasing dose for 16…

Design

RCT, randomly grouped, open label

Follow-up

16 weeks

Authors

RHRozina HoqueMRM. S. RahmanMIMuhammad Usman Iqbal

Discussion

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Overview

Maximum-dose enalapril reduces proteinuria more than losartan in diabetic nephropathy; extends RCT comparisons but neither suffices for BP or proteinuria control.

Structured PICO

Does enalapril reduce proteinuria compared to losartan in patients with type 2 diabetic nephropathy?

P
Population
18 patients with type 2 diabetic nephropathy (proteinuria ≥ 0.5 gm/day and serum creatinine <3 mg/dL)
I
Intervention
Enalapril 5-40 mg/day in increasing dose for 16 weeks
C
Comparator
Losartan 25-200 mg/day in increasing dose for 16 weeks
O
Outcome
Proteinuria (urinary total protein and protein creatinine ratio)surrogate

In a small cohort of patients with type 2 diabetic nephropathy, maximum dose enalapril (40 mg) showed a significant reduction in protein creatinine ratio compared to maximum dose losartan (200 mg), though neither drug sufficiently reduced overall proteinuria or blood pressure.

Cite This Study

Hoque et al. (2009) studied this question.

synapsesocial.com/papers/6a70fe9ca528af2d65c3da49https://doi.org/10.3329/bmrcb.v35i2.2885
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Also Consider

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  1. 1Optimal dose of losartan for renoprotection in diabetic nephropathy2002 · 70 citations
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