Abstract

ACE-inhibitors and angiotensin II receptor blockers (ARB) are able to decrease proteinuria in diabetic nephropathy and several glomerular diseases and they can slow the progresion of chronic renal failure in some nephropathies.

However, it has been demonstrated that ACE-inhibitors and ARB increase the serum potassium levels in patients with chronic renal failure or diabetes. Previous results indicate that increases in serum potassium are less likely with Valsartan (ARB) compared with Lisinopril (ACE-inhibitor) in people with renal insufficiency (Bakris GL et al.:Kidney Int 2000;58(5):2084-92).

Objetive: This is a a comparative study between Enalapril and Losartan on the changes in serum potassium in normotensive patients with diabetic nephropathy and normal renal function.

Design and Methods: The study was an open, crossover design with each period lasting 2 months. 10 patients (5M, 5F) with type 2 diabetes, normotensives, proteinuric and with normal renal function were included in the study.

Results:

There was not significant difference in serum potassium between Enalapril vs Losartan periods 5,52±0,55 vs 5,48±0,51 mEq/l. There was no difference in blood pressure control, weight, serum creatinine or proteinuria excretion 1,99±0,57 vs 2,09±0,61 gr/24 hours.

Conclusion:

Enalapril and Losartan increase serum potassium to similar level in patients with diabetic nephropathy and normal renal function.

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