ACE inhibitors and ARBs are essential for nephroprotection in patients with diabetes and hypertension, with their combination offering potential additional benefits.
May support ACEI/ARB prioritization in diabetic nephropathy; leaves open optimal regimens for prospective trials.
Diabetes mellitus and arterial hypertension are major risk factors of cardiovascular complications. Diabetic nephropathy is the most common cause of end-stage chronic renal failure in the world; next is hypertensive nephropathy. Microalbuminuria is the earliest clinical marker of renal dysfunction. The basic clinical significance of microalbuminuria is that it is an independent risk factor of both end-stage chronic renal failure and cardiovascular complications. Controlling blood pressure with antihypertensive agents in patients with diabetes mellitus ensures diminished microalbuminuria and retards the development of chronic renal failure. Angiotensin II receptor blockers and angiotensin-converting enzyme (ACE) inhibitors are essential drugs for the treatment of patients with diabetes mellitus and nephropathy. A combination of these two classes of drugs offers new prospects for nephroprotection in this group of patients.
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Ostroumova et al. (2003) studied this question.
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