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Nephrology Dialysis Transplantation 2006 21(9):2354-2357; doi:10.1093/ndt/gfl454
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Editorial Comment

Renoprotection by blocking the RAAS in diabetic nephropathy—fact or fiction?

Peter Rossing1, Hans-Henrik Parving1,2 and Dick de Zeeuw3

1 Steno Diabetes Center, Gentofte and 2 Faculty of Health Sciences, University of Aarhus, Aarhus, Denmark and 3 Department of Clinical Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

Correspondence and offprint requests to: Peter Rossing, MD, DMSc, Steno Diabetes Center, Niels Steensens Vej 2, DK 2820 Gentofte, Denmark. Email: pro@steno.dk

Keywords: ACE inhibitors; albuminuria cohort study; angiotensin receptor antagonists; diabetic nephropathy; renoprotection

The first 150 words of the full text of this article appear below.

Diabetic nephropathy is characterized by proteinuria, blood pressure elevation, a relentless decline in renal function and a high risk of cardiovascular disease. In 1992, based on clinical studies, it was suggested that angiotensin-converting enzyme inhibitors (ACEIs) offer renoprotection in diabetic nephropathy—i.e. an effect protecting the kidney function above and beyond what was offered by similar blood pressure reduction with other antihypertensive agents [1]. This study was conducted in type 1 diabetic patients with moderately impaired renal function. The finding was confirmed and extended by the Collaborative Study Group [2] in a study with a median follow-up, 3 years; range, 1.8–4.8, demonstrating that in type 1 diabetic patients, ACEIs were associated with a 50% [95% confidence intervals (CI) 18–70] reduced risk of dialysis/transplantation or death. Subsequently blockade of the renin–angiotensin system (RAS) was investigated in type 2 diabetic patients using angiotensin II receptor blockers (ARB), and a . . . [Full Text of this Article]



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   Meta-analysis
 


   Cohort study
 

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