January 1, 2008Postgraduate Medicine
Comparison of Dual RAAS Blockade and Higher-Dose RAAS Inhibition on Nephropathy Progression
Why the study?
Does higher-dose RAAS inhibition or dual RAAS blockade reduce proteinuria and slow nephropathy progression?
Population
Patients at risk for nephropathy progression, particularly those with diabetes mellitus and proteinuria
Comparison
Higher doses of RAAS inhibition or dual RAAS… vs Standard-dose RAAS inhibition
Design
Review
Authors
Discussion
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Implication
Should not alter RAAS monotherapy practice; hypothesis-generating for intensified blockade pending outcome trials.
Structured PICO
Does higher-dose RAAS inhibition or dual RAAS blockade reduce proteinuria and slow nephropathy progression?
P
Population
Patients at risk for nephropathy progression, particularly those with diabetes mellitus and proteinuria
I
Intervention
Higher doses of RAAS inhibition or dual RAAS blockade (combination of an ACE inhibitor and an ARB)
C
Comparator
Standard-dose RAAS inhibition
O
Outcome
Reduction in proteinuria and slowing of nephropathy progressionsurrogate
This review discusses the theoretical and clinical evidence supporting the hypothesis that dual RAAS blockade or higher-dose RAAS inhibition provides greater renoprotection by further reducing proteinuria.
Cite This Study
Bakris et al. (2008) studied this question.