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Tomomi Fujisawa, Hiroshi Ikegami, Masaya Ono, Masanori Nishino, Shinsuke Noso, Yumiko Kawabata, Toshio Ogihara, Combination of half doses of angiotensin type 1 receptor antagonist and angiotensin-converting enzyme inhibitor in diabetic nephropathy, American Journal of Hypertension, Volume 18, Issue 1, January 2005, Pages 13–17, https://doi.org/10.1016/j.amjhyper.2004.08.001
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Abstract
To investigate the renoprotective effect of combination therapy with an angiotensin I converting enzyme inhibitor and an angiotensin type I receptor blocker (ARB) on diabetic kidney disease, half doses of each monotherapy were given to type 2 diabetic patients with albuminuria.
Urinary albumin index (UAI) and blood pressure (BP) were measured in a total of 27 outpatients with type 2 diabetes mellitus receiving 10 mg imidapril or 8 mg candesartan per day. Either agent was then substituted with a combination of 5 mg imidapril and 4 mg candesartan. After 3 months of combination therapy, UAI and BP were measured. Changes in the parameters were assessed by paired t test.
Although BP was not significantly different prior to and at the end of combination therapy, log-transformed UAI was significantly reduced (P = 0.003) from an initial UAI (mean log-transformed UAI ± SD) of 79.4 (27.4–231)mg/g Cre to 52.5 (17.1–161)mg/g Cre at the end of combination therapy. The reduction was not associated with the initial UAI, initial BP, decrease in BP, pretreatment medication or other concomitant antihypertensive agents.
In patients with type 2 diabetes and nephropathy, dual blockade of the renin system with an angiotensin-converting enzyme inhibitor and angiotensin receptor blocker significantly reduces albuminuria and, thus, may be renoprotective even when the doses of the agents are reduced by one half. Am J Hypertens 2005; 18:13–17 © 2005 American Journal of Hypertension, Ltd.
- angiotensin-converting enzyme inhibitors
- angiotensins
- antihypertensive agents
- hypertension
- kidney diseases
- diabetes mellitus
- diabetic nephropathy
- renin
- angiotensin-converting enzyme
- albumins
- angiotensin receptor antagonists
- diabetes mellitus, type 2
- blood pressure
- combined modality therapy
- outpatients
- urinary tract
- candesartan cilexetil
- antagonists
- paired t-test
- receptor, angiotensin, type 1
- albuminuria