Key result
In proteinuric diabetic nephropathy, renin-angiotensin system blockade is indicated, but monotherapy is practically always insufficient to achieve target blood pressure values.
Renin-angiotensin system blockade is the indicated treatment for proteinuric diabetic nephropathy, though combination therapy is typically required to reach blood pressure goals.
Answers are grounded in this paper and cite their sources.
May warrant combination therapy for BP control in proteinuric diabetic nephropathy; leaves open optimal regimens for prospective trials.
Hypertension is common in patients with diabetes mellitus and is a main cause of renal and cardiovascular complications. There has been recent controversy on what should be considered the optimal blood pressure goal and the optimal antihypertensive agent. It has become apparent that one blood pressure does not fit all in diabetic patients. Major confounders are preexisting cardiovascular disease and presence or absence of proteinuric kidney disease. In proteinuric diabetic nephropathy, renin-angiotensin system blockade is clearly indicated, but monotherapy is practically always insufficient to achieve target blood pressure values.
No takes yet. Share an insight, caveat, or question.
Eberhard Ritz (2011) conducted a review in Hypertension in Diabetes and Diabetic Nephropathy. Angiotensin-Converting Enzyme Inhibitors was evaluated. In proteinuric diabetic nephropathy, renin-angiotensin system blockade is indicated, but monotherapy is practically always insufficient to achieve target blood pressure values.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: