Key result
Combining ACE inhibitors and ARBs reduces the progression of diabetic nephropathy more than either drug alone, but requires close monitoring of serum creatinine and potassium.
Why the study?
Does dual blockade of the renin-angiotensin system with ACE inhibitors and ARBs reduce progression of diabetic nephropathy compared to monotherapy?
Does dual blockade of the renin-angiotensin system with ACE inhibitors and ARBs reduce progression of diabetic nephropathy compared to monotherapy?
Dual blockade of the renin-angiotensin system with ACE inhibitors and ARBs may offer greater benefits in reducing diabetic nephropathy progression than monotherapy, but requires careful monitoring of renal function and potassium.
Answers are grounded in this paper and cite their sources.
May support dual ACEI/ARB use in select diabetic nephropathy cases with monitoring; leaves open confirmation in contemporary RCTs.
Albuminuria and hypertension are predictors of poor renal and cardiovascular outcome in patients with diabetic nephropathy (DN). Intensive treatment requires blockade of the renin-angiotensin system (RAS) by either angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB), which reduce blood pressure and proteinuria. Combining the two therapies has shown greater benefits than either drug alone to reduce progression of DN. Although treatment goals are more likely to be achieved with the combination, this requires close monitoring of serum creatinine and potassium which invariably rise on such therapy.
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De et al. (2006) conducted a review in diabetic nephropathy. Dual blockade of renin-angiotensin system (ACE inhibitors and ARBs) vs. Either drug alone was evaluated on progression of diabetic nephropathy. Combining ACE inhibitors and ARBs reduces the progression of diabetic nephropathy more than either drug alone, but requires close monitoring of serum creatinine and potassium.
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